食管癌患者术后家庭肠内营养健康教育内容的构建及实践研究

doi:10.3761/j.issn.1672-9234.2025.10.015

摘要/Abstract

摘要：

目的构建食管癌术后患者家庭肠内营养健康教育内容，并评估其临床应用效果。方法通过文献研究和小组讨论拟订内容初稿，经2轮专家函询，形成内容终稿。采用便利抽样法，选取2024年3月—8月于河北省某三级甲等医院接受食管癌切除术且术后经鼻肠管接受营养支持治疗的94例患者作为研究对象，将3月—5月接受手术的患者纳入对照组，将6月—8月接受手术的患者纳入试验组，每组各47例。对照组接受常规健康教育，基于构建的健康教育内容对试验组展开健康教育，比较干预期间两组并发症发生率，干预前、4周后两组的营养指标（体重、血清白蛋白），以及干预4周后两组生活质量评分。结果构建的内容由6个一级条目、27个二级条目、18个三级条目组成；各层级条目的一致性比率为<0.001~0.052。最终试验组中43例、对照组中45例完成研究。试验组干预期间总体并发症发生率、腹泻发生率低于对照组（P<0.05）。干预4周后试验组体重与干预前相比，差异无统计学意义（P>0.05），而对照组体重明显下降（P<0.001）；试验组生活质量总得分及各维度得分高于对照组（P<0.05）。结论食管癌术后患者家庭肠内营养健康教育内容具有较高的科学性、系统性，基于其开展的健康教育能有效维持患者的营养状态，降低其并发症发生率，改善其生活质量。

关键词: 食管肿瘤, 家庭肠内营养, 健康教育, 德尔菲法

Abstract:

Objective To construct the health education content for home enteral nutrition for patients after esophageal cancer surgery and evaluate its clinical application effect. Methods The first draft of the content was formulated through literature research and group discussion，and the final draft was formed after two rounds of expert consultation. Using the convenience sampling method，94 patients who underwent esophageal cancer resection in a Grade-A tertiary hospital in Hebei Province from March to August 2024 were selected as the participants. The patients who underwent surgery from March to May were included in the control group，and those who underwent surgery from June to August were included in the experimental group，with 47 cases in each group. The control group received routine health education，while the experimental group received health education based on the constructed health education content. The incidence of complications during the intervention period，nutritional indicators（body weight，serum albumin） before and 4 weeks after the intervention，and the quality of life scores 4 weeks after the intervention were compared between the two groups. Results The constructed content consisted of six first-level items，27 second-level items，and 18 third-level items；the consistency ratio of items at all levels was <0.001~0.052. Finally，43 cases in the experimental group and 45 cases in the control group completed the study. The overall incidence of complications and the incidence of diarrhea in the experimental group during the intervention period were lower than those in the control group（P<0.05）. There was no statistically significant difference in the body weight of the experimental group 4 weeks after the intervention compared with that before the intervention（P>0.05），while the body weight of the control group decreased significantly（P<0.001）；the total quality of life score of the experimental group was higher than that of the control group（P<0.05）. Conclusion The constructed health education content for home enteral nutrition for patients after esophageal cancer surgery in this study is highly scientific and systematic. Health education based on it can effectively maintain the nutritional status of patients，reduce the incidence of complications，and improve their quality of life.

Key words: Esophageal Neoplasms, Home enteral nutrition, Health education, Delphi method

田伟然, 刘磊, 李振华, 宫雅昆, 王翠荣, 张丽, 刘培, 陈璐. 食管癌患者术后家庭肠内营养健康教育内容的构建及实践研究[J]. 中华护理教育, 2025, 22(10): 1242-1249.

TIAN Weiran, LIU Lei, LI Zhenhua, GONG Yakun, WANG Cuirong, ZHANG Li, LIU Pei, CHEN Lu. Construction and clinical application of home enteral nutrition health education content after esophageal cancer surgery[J]. Chinese Journal of Nursing Education, 2025, 22(10): 1242-1249.

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