| 吴 丹,李苏宜.营养代谢技术治疗肿瘤相关综合征临床建议路径[J].肿瘤学杂志,2022,28(12):998-1002. |
| 营养代谢技术治疗肿瘤相关综合征临床建议路径 |
| Recommendation on Clinical Pathway of Nutritional Metabolic Therapy for Cancer-associated Syndromes |
| 投稿时间：2022-11-16 |
| DOI：10.11735/j.issn.1671-170X.2022.12.B004 |
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| 中文关键词: 营养 代谢 治疗 肿瘤相关综合征 |
| 英文关键词:nutrition metabolism treat cancer-associated syndromes |
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| 摘要点击次数: 579 |
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| 中文摘要: |
| 摘 要：肿瘤患者常伴蛋白质和葡萄糖代谢异常、癌因性疲乏、高凝状态、抑郁焦虑症、癌症疼痛、发热、消化道梗阻、胸腹腔积液及皮下水肿等，积极处置这些肿瘤相关综合征是肿瘤营养代谢内科不可或缺的部分。例如，依据胃肠道功能补足热量营养素，联合代谢调节治疗和抗肿瘤药物治疗，可逆转骨骼肌丢失；葡萄糖代谢异常可通过减少葡萄糖供给，提高脂肪能量来源比率，使甘油部分取代葡萄糖来改善；对因和对症治疗可缓解癌因性疲乏；低分子肝素等可降低静脉血栓栓塞症发生；抑郁焦虑需筛查评估；对癌痛者行规范化全程管理；消化道梗阻者，需降低胃肠压力联合消除梗阻部位水肿、减少肠腔液体分泌、营养支持、代谢调节及抗肿瘤治疗等；浆膜腔积液者，应用利尿剂，局部腔内注射血管抑制剂。本临床路径着重论述营养代谢技术治疗肿瘤相关综合征，旨在为广大临床医师、临床营养师等提供相应治疗流程，希望为其提供有益的借鉴。 |
| 英文摘要: |
| Abstract： Cancer patients are often accompanied by abnormal protein and glucose metabolism， cancer related fatigue， hypercoagulability， depression， anxiety， cancer pain， fever， gastrointestinal obstruction， pleural and peritoneal effusion， and subcutaneous edema. These cancer-associated syndromes can be managed through nutritional metabolic therapy. The skeletal muscle loss can be reversed supplement of calorie nutrients， combined with metabolic regulation and anti-tumor treatment； the abnormal glucose metabolism can be alleviated by reducing glucose supply， increasing fat energy source ratio and using glycerol to partially replace glucose； causal and symptomatic treatment can relief cancer related fatigue； low molecular weight heparin can reduce the incidence of venous thromboembolism； screening and evaluation are needed for depression and anxiety and the standardized whole-process management is required for cancer pain. For gastrointestinal obstruction need to reduce gastrointestinal pressure and eliminate obstruction edema， reduce intestinal fluid secretion， nutritional support， metabolic regulation and anti-tumor therapy. Diuretics and local cavity injection of vascular inhibitors are applicable to treat serous cavity effusion. This clinical pathway focuses on the treatment of cancer-associated syndromes with nutrition metabolism technology， which provides reference for clinician and clinical dietitians. |
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