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中华关节外科杂志(电子版) ›› 2023, Vol. 17 ›› Issue (02) : 248 -252. doi: 10.3877/cma.j.issn.1674-134X.2023.02.014

综述

关节外科加速康复中营养筛查的应用与展望
潘莹, 许珂, 鲁超, 许鹏()   
  1. 710054 西安交通大学附属红会医院
  • 收稿日期:2022-04-16 出版日期:2023-04-01
  • 通信作者: 许鹏

Application and outlook of nutritional screening in enhanced recovery after joint surgery

Ying Pan, Ke Xu, Chao Lu, Peng Xu()   

  1. Honghui Hospital, Xi'an Jiaotong University, Xi'an 710054, China
  • Received:2022-04-16 Published:2023-04-01
  • Corresponding author: Peng Xu
引用本文:

潘莹, 许珂, 鲁超, 许鹏. 关节外科加速康复中营养筛查的应用与展望[J]. 中华关节外科杂志(电子版), 2023, 17(02): 248-252.

Ying Pan, Ke Xu, Chao Lu, Peng Xu. Application and outlook of nutritional screening in enhanced recovery after joint surgery[J]. Chinese Journal of Joint Surgery(Electronic Edition), 2023, 17(02): 248-252.

营养作为加速外科多学科会诊(MDT)中的一个环节,患者的营养状态影响膝髋关节置换术后的加速康复,但目前针对患者营养状态的评估手段十分有限(目前相关研究中,大多仅使用白蛋白计数、淋巴计数、及转铁蛋白作为营养不良的标志物,或者直接用评估替代筛查),这样的手段很难精准识别存在营养风险的患者。本文旨在通过回顾关节外科营养筛查的应用现状,分析其可受益因素,提示关节外科医师营养筛查在加速康复中的重要性,为关节外科加速康复中精准营养的发展增加佐证素材。

As a part of the multi-disciplinary treatment (MDT) in enhanced recovery after surgery (ERAS), the nutritional status of a patient affects ERAS after knee and hip arthroplasties. However, there are limited tools available to assess the nutritional status of patients as most studies only tested only albumin counts, lymphcyte counts and transferrin as markers of malnutrition, or even directly replaced the assessment tests with screening, which makes it difficult to accurately identify the patients who are at a nutritional risk. The aims of this paper were to review the current use of nutritional screening in joint surgery, analyse the factors that could benefit from nutritional screening, put forward the importance of nutritional screening for joint surgeons in ERAS, and provide evidences to the development of precision nutrition in accelerated rehabilitation in joint surgery.

图1 PONS (围手术期营养筛查)流程图注:BMI-身体质量指数body mass index
Figure 1 Flow chart of PONS (preoperative nutrition screening)
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