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. |
| [1] | 李丹妮, 邱丽燕, 吴隆燕, 谭铮可可, 陈欣, 杨丽. 前交叉韧带损伤日间手术患者恐动症的潜在剖面分析及影响因素研究[J]. 护理学报, 2025, 32(4): 12-17. |
| [2] | 杜易梅, 刘莉, 郭立丽, 卢吉, 付苗苗, 刘杰. 妇科恶性肿瘤患者性健康研究进展[J]. 护理学报, 2025, 32(4): 28-33. |
| [3] | 李疆伟, 王树君, 李长仔, 胡宝山, 焦桂梅, 张卫红. 基于压力应对理论的护理干预对结直肠癌术后永久性肠造口患者心理压力、负性情绪及自我管理的影响[J]. 护理学报, 2025, 32(4): 64-69. |
| [4] | 李长娥, 徐真真, 张文忠, 吴燕, 季红. 新生儿父母脐带血储存决策影响因素的定性研究[J]. 护理学报, 2025, 32(3): 74-78. |
| [5] | 魏利, 赵兴颖, 刘佳, 何雨璇, 陈晓梅, 杨雪, 鲜继淑, 杨燕妮. 神经外科重症住院患者家庭照顾者照顾负担及影响因素分析[J]. 护理学报, 2025, 32(2): 1-6. |
| [6] | 杨蓓, 叶红芳, 张宁, 相卢伟, 路诗雨. 老年2型糖尿病患者体力活动现状及影响因素研究[J]. 护理学报, 2025, 32(2): 7-12. |
| [7] | 刘畅, 张维, 王翠雪, 岳鹏. ICU实施非限制性探视制度的影响因素研究进展[J]. 护理学报, 2025, 32(1): 34-38. |
| [8] | 王进波, 吴姗, 黄蓉蓉, 陈代凤, 洪梅, 李审绥. 头颈癌患者自杀影响因素及干预的研究进展[J]. 护理学报, 2025, 32(1): 39-43. |
| [9] | 陈莹莹, 丁红, 张根生. 患儿术后谵妄影响因素的研究进展[J]. 护理学报, 2024, 31(9): 32-35. |
| [10] | 曹娟, 李方, 于跃, 戴丽, 杨丹丹, 李志华, 徐欣怡, 戴琪, 陈柯宇. 食管癌术后静脉血栓栓塞症风险预测模型的构建及验证[J]. 护理学报, 2024, 31(8): 63-68. |
| [11] | 朱心悦, 嵇冰聪, 蓝雪芬, 季晓珍. 糖尿病患者电子健康素养研究进展[J]. 护理学报, 2024, 31(7): 36-39. |
| [12] | 李莹, 周志欢. ICU护理缺失的研究进展[J]. 护理学报, 2024, 31(6): 43-46. |
| [13] | 黄鑫, 余丽君, 张二明, 哈丽娜. 稳定期COPD患者的能量摄入现状及影响因素分析[J]. 护理学报, 2024, 31(5): 12-16. |
| [14] | 张思爱, 赖翠薇, 李佳佳, 张亚军, 汪张毅, 张正涛, 法天锷. 护士专业态度的影响因素研究进展[J]. 护理学报, 2024, 31(4): 38-41. |
| [15] | 林梅燕, 张星星, 李瑞华, 陶思琪, 甄莉. 肠造口患者居家睡眠质量特点及影响因素研究进展[J]. 护理学报, 2024, 31(24): 27-32. |
|
||