护理学报 ›› 2024, Vol. 31 ›› Issue (1): 42-45.doi: 10.16460/j.issn1008-9969.2024.01.042
高流量造口患者营养管理策略的研究进展
宋思梦1, 李杨2, 初丽丽2, 王辉2, 杨科力2, 田晓迎1
- 1.暨南大学 护理学院,广东 广州 510632;
2.中山大学附属第六医院,广东 广州 510655
摘要： 目的 综述国内外高流量造口患者营养管理策略,以期为制定个性化营养干预方案提供参考和依据。方法 通过检索国内外相关数据库,综述了高流量造口的概况、营养不良的表现与危害、营养评估与监测、营养支持策略及营养管理效果的影响因素。结果 高流量造口的发生率较高,但其识别率较低。随着造口排量的增加,患者逐渐出现各种并发症,对生活质量和康复产生严重影响。尽管存在一些营养评估指标和管理策略,但它们在临床实践中的应用尚显不足,对于有效解决高流量带来的挑战以及提供充分的营养支持,我们的了解还有待加强。结论 在高流量造口患者营养管理方面,迫切需要深入研究制定个性化管理方案,以改善患者营养状况并提高生活质量。
中图分类号:
- R459.3
| [1] 赵泽英,邓颖辉,丁妮,等.肠造口高排量的研究进展[J].护理研究,2020,34(2):291-294. [2] Lederhuber H,Massey LH,Kantola VE,et al.Clinical management of high-output stoma:a systematic literature review and Meta-analysis[J].Tech Coloproctol,2023,27(12):1139-1154.DOI:10.1007/s10151-023-02830-1. [3] Hara Y, Miura T, Sakamoto Y,et al.Organ/space infection is a common cause of high output stoma and outlet obstruction in diverting ileostomy[J]. BMC Surgery,2020,20(1):83.DOI: 10.1186/s12893-020-00734-7. [4] Santamaria MM,Villafranca J,Abiles J,et al.Impact of a nutrition consultation on the rate of high output stoma-related readmission:an ambispective cohort study[J].Sci Rep, 2021,11(1):16620.DOI:10.1038/s41598-021-96136-7. [5] Fielding A,Woods R,Moosvi SR,et al.Renal impairment after ileostomy formation:a frequent event with long-term consequences[J]. Colorectal Dis,2020,22(3):269-278.DOI: 10.1111/codi.14866. [6] Borucki JP,Schlaeger S,Crane J,et al.Risk and consequences of dehydration following colorectal cancer resection with diverting ileostomy.A systematic review and Meta-analysis[J].Colorectal Dis,2021,23(7):1721-1732.DOI:10.1111/codi.15654. [7] Vogel I, Shinkwin M, Storm SL, et al.Overall readmissions and readmissions related to dehydration after creation of an ileostomy: a systematic review and Meta-analysis[J].Tech Coloproctol,2022,26(5):333-349.DOI:10.1007/s10151-022-02580-6. [8] Zhang Q, Sun J, Wang D,et al.Knowledge,attitudes,practices and associated factors regarding high output stoma of ileostomy among colorectal surgical nurses:a multicentre cross-sectional study[J].Support Care Cancer,2023,32(1):12.DOI:10.1007/s00520-023-08228-x. [9] 郭雅萍,郭淑丽,李敏,等.行动研究法对提高普外科护士肠造口护理能力的效果研究[J].护理学报,2020,27(12):6-9.DOI:10.16460/j.issn1008-9969.2020.12.006. [10] Seifarth C, Augustin LN, Lehmann KS,et al.Assessment of risk factors for the occurrence of a high-output ileostomy[J].Front Surg,2021,8:642288.DOI:10.3389/fsurg.2021.642288. [11] Oliveira AL, Boroni MA, Pereira NM,et al.A cross-sectional study of nutritional status, diet, and dietary restrictions among persons with an ileostomy or colostomy[J]. Ostomy Wound Manage,2018, 64(5):18-29.DOI:10.25270/owm.2018.5.1829. [12] England C, Mitchell A, Atkinson C.Diet after ileostomy study:an observational study describing dietary intake and stoma-related symptoms in people with an ileostomy[J]. J Hum Nutr Diet,2023,36(4):1600-1612.DOI:10.1111/jhn.13168. [13] 王凯,邓云烜,杨超,等.回肠造口性腹泻的早期识别和处理的研究进展[J].中国普通外科杂志,2022,31(4):521-526. [14] Nightingale JM.How to manage a high-output stoma[J].Frontline Gastroenterol, 2021,13(2):140-151.DOI:10.1136/flgastro-2018-101108. [15] Matsuzawa H, Munakata S, Kawai M, et al.Analysis of ileostomy stool samples reveals dysbiosis in patients with high-output stomas[J]. Biosci Microbiota Food Health, 2021,40(3):135-143.DOI:10.12938/bmfh.2020-062. [16] Baker ML, Williams RN,Nightingale JM.Causes and management of a high-output stoma[J]. Colorectal Dis 2011,13(2):191-197.DOI:10.1111/j.1463-1318.2009.02107.x. [17] Tsujinaka S, Suzuki H,Miura T,et al.Obstructive and secretory complications of diverting ileostomy[J]. World J Gastroenterol, 2022, 28(47):6732-6742.DOI:10.3748/wjg.v28.i47.6732. [18] Culkin A,Gabe SM,Nightingale J.A new palatable oral rehydration solution:a randomised controlled cross-over study in patients with a high output stoma[J]. J Hum Nutr Diet,2022,35(1):94-101.DOI:10.1111/jhn.12935. [19] Fernandez A,Rivera S,Duran V M,et al.Nutritional and educational intervention to recover a healthy eating pattern reducing clinical ileostomy-related complications[J]. Nutrients,2022,14(16).DOI:10.3390/nu14163431. [20] Mitchell A, England C,Perry R,et al.Dietary management for people with an ileostomy:a scoping review[J]. JBI Evid Synth, 2021, 19(9):2188-2306.DOI:10.11124/JBIES-20-00377. [21] 李素云,邵小平,唐小丽,等.肠外营养安全输注专家共识[J].中华护理杂志, 2022,57(12):1421-1426. [22] Rowe KM, Schiller LR.Ileostomy diarrhea:pathophysiology and management[J]. Proc, 2020, 33(2):218-226.DOI:10.1080/08998280.2020.1712926. [23] Ahmad SJ,Khan A,Madhotra R,et al.Semi-elemental diet is effective in managing high output ileostomy;a case report[J].Gastroenterol Hepatol Bed Bench,2019,12(2):169-173. [24] Ried K,Travica N,Dorairaj R,et al.Herbal formula improves upper and lower gastrointestinal symptoms and gut health in Australian adults with digestive disorders[J]. Nutr Res, 2020,76:37-51.DOI:10.1016/j.nutres.2020.02.008. [25] Simon E, Calinoiu LF,Mitrea L,et al.Probiotics,prebiotics,and synbiotics:implications and beneficial effects against irritable bowel syndrome[J]. Nutrients,2021,13(6):2112. DOI:10.3390/nu13062112. [26] Myhrstad M, Tunsjo H, Charnock C,et al.Dietary fiber,gut microbiota,and metabolic regulation-current status in human randomized trials[J]. Nutrients,2020,12(3):859. DOI:10.3390/nu12030859. [27] Tabasum S, Noreen A, Maqsood MF, et al.A review on versatile applications of blends and composites of pullulan with natural and synthetic polymers[J].Int J Biol Macromol, 2018,120(Pt A):603-632.DOI:10.1016/j.ijbiomac.2018.07.154. [28] Clarebrough E, Guest G, Stupart D.Eating marshmallows reduces ileostomy output: a randomized crossover trial[J].Colorectal Dis,2015,17(12):1100-1103.DOI: 10.1111/codi.12992. [29] Ho CY, Ahmad AF, Sian WS, et al.Integrate partial hydrolyzed guar gum in postoperative ileostomy nutritional management[J]. J Med Res Innovat, 2020,4:e206.DOI:10.32892/jmri.206. [30] 陈燕林. 造口患者造口高排量的相关因素分析及护理[J].护理学杂志,2017,32(10):33-35. [31] Ohta H, Miyake T,Ueki T,et al.Predictors and clinical impact of postoperative diarrhea after colorectal cancer surgery:a prospective,multicenter,observational study (SHISA-1602)[J]. Int J Colorectal Dis,2022,37(3):657-664.DOI:10.1007/s00384-022-04097-8. [32] Bai D, Li L, Shen Z,et al.Risk factors for developing high-output ileostomy in CRC patients:a retrospective study[J].BMC Surg, 2021,21(1):300.DOI:10.1186/s12893-021-01288-y. [33] Takeda M,Takahashi H,Haraguchi N,et al.Factors predictive of high-output ileostomy:a retrospective single-center comparative study[J].Surg Today,2019,49(6):482-487.DOI: 10.1007/s00595-018-1756-2. |
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