目的 调查消化系统恶性肿瘤患者营养风险、营养知识-态度-行为（知信行）水平的现状，探究各因素是否对患者的营养风险、营养知信行水平具有影响，并分析两者之间的相关性。方法 选取中山大学附属第八医院（深圳福田）2024年2月—10月的244例消化系统恶性肿瘤患者为研究对象，采用一般资料调查表、营养风险筛查NRS2002量表以及消化系统肿瘤患者营养知信行问卷进行调查，数据收集后进行统计分析，从而研究消化系统恶性肿瘤患者营养筛查风险与营养知信行水平的现状、影响因素及两者间的相关性。结果 69.3%的消化系统恶性肿瘤患者存在营养风险，营养风险评分为（2.72±1.42）分。消化系统恶性肿瘤患者营养知识水平得分为（12.30±5.26）分、营养态度水平得分为（14.80±2.68）分、营养行为水平得分为（22.82±4.55）分、营养知信行水平总分为（49.96±9.50）分。家庭经济收入是患者营养风险水平的核心影响因素（P＜0.05），学历水平是患者营养知信行水平的核心影响因素（P＜0.05）。消化系统恶性肿瘤患者营养风险水平与营养知信行的总体水平呈负相关（r=-0.143，P＜0.05）。结论 消化系统恶性肿瘤患者的营养知信行水平总体处于中等水平，但普遍存在营养风险较高的情况。在患者治疗期间实施个性化营养健康宣教至关重要，这将有助于提升患者的营养知识水平，从而整体性改善其营养知信行素养并降低其营养风险，但在进行营养宣教和制定个性化营养方案时应充分考虑患者的家庭经济收入及学历水平。

    Objective To explore the nutritional risk and nutritional knowledge-attitude-behavior status of patients with digestive system malignant tumors，to analyze the influencing factors of nutritional risk，nutritional knowledge-attitude-behavior，and explore the correlation between them．Methods From February 2024 to October 2024，244 patients with digestive system malignant tumors at the Eighth Affiliated Hospital of Sun Yat-sen University were selected as the research subjects．A general information questionnaire，Nutritional Risk Screening 2002，and digestive system tumor patient nutrition knowledge-attitude-behavior questionnaire were used to study the influencing factors and correlations between the nutritional screening risk and nutritional knowledge-attitude-behavior in patients with digestive system malignant tumors．Results There were 69.3% of the patients with digestive system malignant tumors had nutritional risk score ≥3，and the overall score was（2.72±1.42）．The scores of nutritional knowledge，attitude，behavior and total score of digestive system malignant tumors patients were（12.30±5.26），（14.80±2.68），（22.82±4.55）and（49.96±9.50），respectively．Family economic income was the core influencing factors of nutritional risk in patients with digestive system malignant tumors，while educational level was the core influencing factor of nutritional knowledge-attitude-behavior in patients with digestive system malignant tumors．The nutritional risk level of patients with malignant tumors of the digestive system was significantly negatively correlated with the overall level of nutritional knowledge-attitude-behavior．Conclusions The nutritional knowledge-attitude-behavior level of patients with malignant tumors of the digestive system is generally at a medium level，but there is a widespread situation of relatively high nutritional risk．It is extremely important and necessary to conduct personalized nutrition knowledge education for patients during their treatment period，which will help enhance patients’ nutritional knowledge level，thereby comprehensively improving their nutritional knowledge-attitude-behavior literacy and reducing their nutritional risks．However，when conducting nutrition education and formulating personalized nutrition plans，the patient’s family economic income，medical payment methods and educational level should be fully considered．

摘要目的 探讨基于E-Coach健康管理模式的营养管理联合主动循环呼吸训练（ACBT）在非小细胞肺癌（NSCLC）化疗患者中的应用效果。方法 选取2023年6月至2025年8月我院收治的98例NSCLC化疗患者，采用随机数字表法将所有研究对象分为联合组和常规组，每组49例。常规组给予常规干预，联合组在常规组基础上予以E-Coach健康管理模式的营养管理联合ACBT干预。比较两组干预前后营养状况、肺功能、运动耐力、生活质量以及营养不良发生率。结果 干预12周后，两组BMI、ALB、PA、Hb均较干预前上升且联合组高于常规组（P<0.05）；联合组FVC、FEV1、MVV及6MWT均显著高于常规组（P＜0.05）；干预前两组6MWT组间对比差异无统计学意义（P>0.05），干预4周、6周、8周、12周后，两组6MWT均较干预前增加，且联合组远于常规组（P<0.05）；干预12周后，两组身体功能、社会或家庭功能、情感功能、功能性状况得分均较干预前上升，且联合组高于常规组（P<0.05）。结论基于E-Coach健康管理模式的营养管理联合ACBT能够有效改善NSCLC化疗患者的营养状况和肺功能，提高生活质量和运动耐力。

Abstract Objective To investigate the application effect of nutrition management based on the E-Coach health management model combined with active cycle of breathing technique (ACBT) in patients undergoing chemotherapy for non-small cell lung cancer (NSCLC). Methods A total of 98 NSCLC patients receiving chemotherapy in our hospital from June 2023 to August 2025 were selected and randomly divided into a combination group and a conventional group using a random number table method, with 49 cases in each group. The conventional group received routine intervention, while the combination group received nutrition management based on the E-Coach health management model combined with ACBT in addition to the routine intervention. The nutritional status, lung function, exercise endurance, quality of life, and incidence of malnutrition were compared between the two groups before and after the intervention. Results After 12 weeks of intervention, BMI, ALB, PA, and Hb in both groups increased compared with baseline, and the levels in the combination group were higher than those in the conventional group (P<0.05). The FVC, FEV1, MVV, and 6MWT in the combination group were significantly higher than those in the conventional group (P<0.05). There was no statistically significant difference in 6MWT between the two groups before intervention (P>0.05); after 4, 6, 8, and 12 weeks of intervention, the 6MWT in both groups increased compared with baseline, and the walking distance in the combination group was significantly longer than that in the conventional group (P<0.05). After 12 weeks of intervention, the scores of physical function, social/family function, emotional function, and functional well-being in both groups increased compared with baseline, and the scores in the combination group were higher than those in the conventional group (P<0.05). Conclusion Nutrition management based on the E-Coach health management model combined with ACBT can effectively improve the nutritional status and lung function of NSCLC patients undergoing chemotherapy, and enhance their quality of life and exercise endurance.

       目的  分析对肺癌化学治疗（化疗）患者采取个性化营养干预联合分级步行运动方案的应用价值。方法   将郑州大学附属郑州中心医院2023年7月—2024年7月符合标准的198例肺癌化疗患者作为研究对象，通过随机数字表法分为观察组和对照组各99例。对照组仅采用个性化营养干预方案，观察组则联合分级步行运动方案，两组患者均在同一时间内入组并接受持续干预3个月。对两组干预前后癌因性疲乏［Piper疲乏修订量表（PFS-R）］、营养状况、睡眠质量［匹茨堡睡眠质量指数（PSQI）］、生活质量［生活质量评估量表（SF-36）］水平予以比较。结果  相较于对照组，干预后观察组PFS-R、PSQI评分较低，白蛋白、前白蛋白、血红蛋白、铁转蛋白水平和SF-36评分较高（P＜0.05）。结论  对肺癌化疗患者采取个性化营养干预联合分级步行运动方案，有利于促进其癌因性疲乏的减轻和营养状态、睡眠质量及生活质量水平的提高。

       Objective  To analyze the effects of personalized nutritional intervention combined with graded walking exercise treatment on cancer-related fatigue and quality of life in lung cancer patients during chemotherapy．Methods  A total of 198 lung cancer patients undergoing chemotherapy who met the criteria in our hospital from July 2023 to July 2024 were selected as the research subjects．They were divided into an observation group and a control group，with 99 cases in each group，by the random number table method．The control group only received individualized nutritional intervention，while the observation group received graded walking exercise additionally．Both groups of patients were enrolled at the same time and received continuous intervention for three months．Cancer-related fatigue（Piper’s Fatigue Scale-Revised［PFS-R］），nutritional status，sleep quality（Pittsburgh Sleep Quality Index［PSQI］），and quality of life（Quality of Life Scale［SF-36］） before and after the intervention were compared between the two groups．Results  Compared with the control group，the observation group had lower PFS-R and PSQI scores and higher albumin，prealbumin，hemoglobin，transferrin levels and SF-36 scores after the intervention（P＜0.05）．Conclusions  Adopting personalized nutritional intervention combined with graded walking exercise for lung cancer patients during chemotherapy is beneficial to promote the reduction of cancer-caused fatigue and the improvement of their nutritional status，sleep quality and quality of life．

       目的 探讨多组分运动干预联合多学科指导下营养干预应用于老年慢性心力衰竭（CHF）并发衰弱患者的效果。方法 选择郑州市第七人民医院收治的CHF并衰弱患者102例, 纳入时间为2023年11月—2024年10月, 按照随机数表法分为对照组51例给予常规运动干预+多学科指导下营养干预,观察组51例给予多组分运动干预+多学科指导下营养干预,观察两组衰弱状态、心功能指标、营养状况、生活质量、不良事件发生率。结果 与对照组相比,观察组干预后身体、心理、社会及总分明显更低（P<0.05）。与对照组相比,观察组干预后左室射血分数（LVEF）水平明显更高,超敏心肌肌钙蛋白T（hs-cTnT）、N末端B型利钠肽前体（NT-proBNP）、左室舒张末期内径（LVEDD）水平更低（P<0.05）。与对照组相比, 观察组干预后主观整体营养状况评价表（PG-SGA）评分明显更低,血红蛋白（Hb）、前白蛋白（PA）、白蛋白（ALB）水平更高（P<0.05）。与对照组相比,观察组干预后症状、身体、情感及总分更低（P<0.05）。观察组不良事件发生率（1.96%）低于对照组（15.69%）（P<0.05）。结论 对CHF并发衰弱患者应用多组分运动干预联合多学科指导下营养干预,能够减轻衰弱状态, 改善心功能及营养状况,促进生活质量的提升, 并降低不良事件发生率。

       Objective To explore the effect of multi-component exercise intervention combined with nutritional intervention under multidisciplinary guidance in elderly patients with chronic heart failure（CHF）and frailty．Methods From November 2023 to October 2024, 102 CHF patients with frailty admitted to Zhengzhou Seventh People's Hospital were selected and included． According to the computer grouping method, they were divided into a control group with 51 patients, received routine exercise intervention and multidisciplinary nutrition intervention,and an observation group with 51 patients, received multi-component exercise intervention and multidisciplinary nutrition intervention．The frailty status, cardiac function indicators, nutritional status, quality of life and incidence of adverse events were observed in both groups．Results Compared with the control group,the observation group showed significantly lower physical, psychological, social, and total scores after intervention（P<0.05）．Compared with the control group, the observation group showed significantly higher levels of left ventricular ejection fraction and lower levels of high-sensitivity cardiac troponin N-terminal pro-B-type natriuretic peptide, and left ventricular end-diastolic dimension after intervention（P<0.05）．Compared with the control group,the observation group had significantly lower Patient-Generated Subjective Global Assessment scores and higher levels of hemoglobin, prealbumin, and albumin after intervention（P<0.05）．Compared with the control group, the observation group had significantly lower symptoms, physical, emotional, and total scores after intervention（P<0.05）．The incidence of adverse events in the observation group（1.96%）was lower than that in the control group（15.69%）（P<0.05）．Conclusions Multi-component exercise intervention combined with multidisciplinary nutritional intervention in patients with CHF and frailty can alleviate frailty, improve cardiac function and nutritional status,quality of life, and reduce the incidence of adverse events．

       目的  本研究旨在探讨不同俯卧位通气（PPV）时间对重症肺炎合并胃肠功能障碍患者肠内营养耐受性的影响。方法  选择2020年7月—2023年7月在天津市人民医院重症监护病房（MICU）治疗的80例重症肺炎合并胃肠功能障碍患者为研究对象, 按每日PPV时间分为长时组（≥12 h, n=40）和短时组（<12 h, n=40）。比较两组患者一般资料、氧合指数、胃肠功能指标[腹内压、血清促胃液素（GAS）和血管活性肠肽（VIP）]、肠内营养达标率、胃肠并发症率等。结果  短时组治疗后, 1 d、3 d、5 d氧合指数为（189.93±33.72）、（247.53±63.01）、（325.03±58.11）mmHg,高于长时组的（161.63±36.88）、（191.83±57.65）、（267.95±46.25）mmHg,均P<0.05; 胃残留量为（29.00±7.92）、（19.75±4.45）、（11.00±1.87） mL低于长时组的（75.03±23.29）、（53.13±11.99）、（21.70±5.52） mL, 均P<0.05。短时组治疗后腹内压[（8.53±2.05）mmHg vs （9.75±2.05） mmHg]、VIP水平[（61.14±7.63） vs （67.49±4.43） pg/mL]低于长时组,GAS水平[（65.02±8.84） vs （54.22±9.21）pg/mL]升高（均P<0.05）。短时组总胃肠并发症发生率（7.50%）低于长时组（25.00%）, P=0.034。结论  对于重症肺炎合并胃肠功能障碍患者,每日PPV时间≤12 h可改善氧合并降低胃肠并发症风险, 可能与减轻腹压、调节胃肠激素分泌及提升肠内营养耐受性相关。

      Objective To explore the effect of different duration of prone position ventilation（PPV）on enteral nutritional tolerance in patients with severe pneumonia combined with gastrointestinal dysfunction．Methods A total of 80 patients with severe pneumonia complicated by gastrointestinal dysfunction were treated in the Medical Intensive Care Unit（MICU）of a hospital from July 2020 to July 2023, and were selected as the research subjects．They were divided into the long-duration group（≥12 hours, n=40）and the short-duration group（<12 hours, n=40）according to the daily duration of PPV．The general data, oxygenation index, gastrointestinal function indicators（intra-abdominal pressure, serum gastrin[GAS] and vasoactive intestinal peptide[VIP]）, enteral nutrition achievement rate, and gastrointestinal complications of the two groups were compared．Results The oxygenation index of the short-duration group at 1 d, 3 d,a nd 5 d after treatment（[189.93±33.72], [247.53±63.01], and[325.03±58.11] mmHg, respectively）was significantly higher than that of the long-duration group（[161.63±36.88], [191.83±57.65], and[267.95±46.25] mmHg,respectively, all P<0.05）．The gastric residual volume of the short-duration group（[29.00±7.92], [19.75±4.45], and[11.00±1.87] mL, respectively）was significantly lower than that of the long-duration group（[75.03±23.29], [53.13±11.99], and[21.70±5.52] mL, respectively, all P<0.05）．The intra-abdominal pressure（[8.53±2.05] vs [9.75±2.05] mmHg）and VIP level（[61.14±7.63] vs [67.49±4.43] pg/mL）of the short-duration group after treatment were significantly lower than those of the long-duration group, while the GAS level（[65.02±8.84] vs [54.22±9.21] pg/mL）was significantly higher（all P<0.05）．The total incidence of gastrointestinal complications in the short-duration group（7.50%）was significantly lower than that in the long-duration group（25.00%, P=0.034）．Conclusions For patients with severe pneumonia complicated by gastrointestinal dysfunction, a daily duration of PPV within 12 hours can improve oxygenation and reduce the risk of gastrointestinal complications, which may be related to the reduction of intra-abdominal pressure, regulation of gastrointestinal hormone secretion, and improvement of enteral nutrition tolerance． 

       目的   调查江西省南昌市东湖区孕妇2022—2024年碘营养状况与盐碘监测情况，为区域干预提供依据。方法   将江西省南昌市东湖区划分为东、南、西、北、中5个片区，每个片区随机抽取一个街道（管理处），于每年5月份随机抽取各街道（管理处）20名孕妇，每年共抽取100名孕妇，3年共计300名孕妇，采集其尿液样本和家中食用盐样本检测碘含量，以统计学方法进行分析。结果  3年来孕妇家庭食用盐碘含量中位数为23.02 mg/kg，碘盐覆盖率为98.67%，碘盐合格率为95.33%，3年的食用盐碘含量比较差异有统计学意义（H=38.545，P＜0.05）。孕妇的尿碘水平中位数为115.15 μg/mL，3年来孕妇的尿碘水平中位数均低于150 μg/mL，有62.67%的孕妇碘缺乏，3年间的尿碘水平比较差异有统计学意义（H=9.392，P＜0.05），其中2024年的尿碘水平中位数为140.00 μg/mL，校正后高于2022年（Z=2.693，P＜0.0167）和2023年（Z=2.590，P＜0.0167）。Spearman相关性分析结果显示孕妇尿碘水平与盐碘含量及碘盐质量均无相关性（均P＞0.05），孕妇碘营养状况与盐碘含量及碘盐质量均无相关性（均P＞0.05），孕妇尿碘水平与碘营养状况正相关（r_s=0.857，P＜0.05），盐碘含量与碘盐质量正相关（r_s=0.314，P＜0.05）。结论   江西省南昌市东湖区2024年孕妇碘缺乏有所改善，但整体形势严峻，超半数的孕妇碘缺乏，食用碘盐基本符合国家消除碘缺乏病标准，但仍需改进。卫生部门要强化孕妇碘营养监测，向孕妇科普碘缺乏病知识，增强补碘意识，促其科学补碘。盐业监管部门需加大监管，严控碘盐质量，确保东湖区居民食盐合格。

       Objective  To investigate the iodine nutrition status of pregnant women and iodined salt monitoring in Donghu District，Nanchang City，Jiangxi Province from 2022 to 2024，and provide a basis for regional intervention．Methods  Donghu District was divided into five areas：East，South，West，North，and Central．A street（management office）was randomly selected from each area，and 20 pregnant women were randomly selected from each street（management office）in May each year．A total of 100 pregnant women were selected each year，for a total of 300 pregnant women over three years．Urine samples and household salt samples were collected to detect iodine content，and statistical analysis was conducted．Results  Over the past three years，the median iodine content in the cooking salt consumed by pregnant women’s families was 23.02 mg/kg，the iodized salt coverage rate was 98.67%，and the iodized salt qualification rate was 95.33%．There were differences in the iodine content of cooking salt in the three years（H=38.545，P＜0.05）．The median urinary iodine level of pregnant women was 115.15 μg/mL．In the past three years，the median urinary iodine levels of pregnant women were all lower than 150 μg/ml，and 62.67% of pregnant women were iodine-deficient．There were differences in the urinary iodine levels in the three years（H=9.392，P＜0.05）．Among them，the median urinary iodine level in 2024 was 140.00 μg/mL，which was significantly higher than that in 2022（Z=2.693，P＜0.0167）and 2023（Z=2.590，P＜0.0167）after correcting the significance level．Spearman correlation analysis  results showed that there was no correlation between the urinary iodine level of pregnant women with the iodine content and quality of iodized salt（all P＞0.05），and there was no correlation between the iodine nutritional status of pregnant women with the iodine content and quality of iodized salt（all P＞0.05）．The urinary iodine level in pregnant women is positively correlated with their iodine nutritional status（r_s=0.857，P＜0.05），and the iodine content in salt is positively correlated with the quality of iodized salt（r_s=0.314，P＜0.05）．Conclusions  In 2024，the iodine deficiency among pregnant women in Donghu District，Nanchang City，Jiangxi Province was improved，but the overall situation is still severe．More than half of pregnant women were iodine-deficient．The consumption of iodized salt basically met the national standards for eliminating iodine deficiency disorders，but still needed to be improved．The health department should strengthen the monitoring of iodine nutrition among pregnant women，popularize knowledge about iodine deficiency disorders to pregnant women，enhance their awareness of iodine supplementation，and promote their scientific iodine supplementation．The salt industry supervision department needs to strengthen supervision，strictly control the quality of iodized salt，and ensure that the cooking salt of residents in Donghu District is qualified．

目的 探讨降钙素原（PCT）联合营养指标对肝硬化营养状况的评定价值。方法 选取2021年2月—2022年3月在右江民族医学院附属医院感染科住院的140例肝硬化患者,根据营养风险筛查2002（NRS 2002）将其分为有营养风险组和无营养风险组。比较两组肝硬化患者中营养指标体质指数（BMI）、血红蛋白（HGB）、前白蛋白（PA）、白蛋白（ALB）、视黄醇结合蛋白（RBP）水平, 并分析它们与PCT的相关性。结果 BMI、HGB、ALB、PA及RBP水平低于低营养风险组（P<0.05）; 营养指标（BMI、HGB、ALB、PA、RBP）与PCT呈负相关（P<0.05）。二元Logistics回归分析发现ALB、PCT是肝硬化患者营养风险的危险因素（P<0.05）。ROC结果显示PCT与ALB的联合营养指标评定肝硬化营养不良的曲线下面积为0.984,（95%CI：0.964~1.000）, 灵敏度98.8%, 特异度93.3%, 约登指数0.921; ALB、PCT的AUC分别为0.919、0.974。结论 肝硬化患者PCT水平与其营养状况密切相关, 对营养状况的评定有一定的价值, 联合评定能有效提高其评定价值。

Objective To explore the value of procalcitonin（PCT）combined with nutritional indexes in evaluating the nutritional status of liver cirrhosis．Methods A total of 140 patients with cirrhosis admitted to the Department of Infection of the Affiliated Hospital of Youjiang Medical College for Nationalities from February 2021 to March 2022, they were selected and divided into with and without nutritional risk group according to nutritional risk screening 2002（NRS 2002）．The levels of body mass index（BMI）, hemoglobin（HGB）, prealbumin（PA）, albumin（ALB）and retinol binding protein（RBP）in two groups of patients with cirrhosis were compared, and the correlation between them and PCT was analyzed．Results The levels of BMI, HGB, ALB, PA and RBP were lower than those of low nutritional risk group（P<0.05）．The nutritional indices（BMI, HGB, ALB, PA, RBP）were negatively correlated with PCT（P<0.05）．Binary Logistics regression analysis showed that ALB and PCT were risk factors affecting nutritional risk in patients with cirrhosis（P<0.05）．ROC results showed that the area under the curve was 0.984（95% confidence interval：0.964 ~ 1.000）, sensitivity 98.8%, specificity 93.3%, and Yoden index 0.921 for the combined PCT and ALB indexes predicting malnutrition in cirrhosis．The AUC of ALB and PCT were 0.919 and 0.974, respectively．Conclusions The level of PCT in patients with cirrhosis is closely related to their nutritional status, which has certain value in the evaluation of nutritional status, and combined prediction can effectively improve the evaluation value．

目的 分析超早期阶梯式协同营养管理在改善重症急性胰腺炎患者喂养中的应用效果。方法 抽取2020年1月—2022年1月南阳市中心医院收治的80例重症急性胰腺炎患者为研究对象,随机数字表法分为观察组和参照组,各40例,两组患者均给予常规营养干预措施,其中观察组患者在以上基础上给予超早期阶梯式协同营养管理,对比两组患者的临床症状消退时间、营养状况、喂养相关并发症、喂养不耐受发生率。结果 与参照组相比,观察组患者的临床症状消退时间更短（P<0.05）,观察组患者的体质量指数、上臂肌围、肱三头肌皮褶厚度及血清清蛋白水平更高（P<0.05）;两组患者的喂养相关并发症主要包括恶心呕吐、误吸、腹泻、感染,观察组患者的喂养相关并发症发生率为7.50%,参照组患者的喂养相关并发症发生率为25.00%,观察组患者的喂养相关并发症发生率低于参照组（P<0.05）;观察组患者喂养不耐受发生2例（5.00%）,参照组患者喂养不耐受发生9例（22.50%）,观察组患者喂养不耐受发生率低于参照组（P<0.05）。结论 重症急性胰腺炎患者实施超早期阶梯式协同营养管理可降低喂养不耐受发生率及喂养相关并发症发生率,改善患者营养水平。

Objective To analyze the application effect of ultra early stepped collaborative nutrition management on improving feeding in patients with severe acute pancreatitis．Methods Eighty patients with severe acute pancreatitis admitted to our hospital from January 2020 to January 2022 were selected as research subjects and randomly divided into observation group and reference group,with 40 cases in each group．Patients in both groups were given conventional nutritional intervention measures,among which patients in the observation group were given super-early stepped collaborative nutritional management on the basis of the above．Clinical symptom resolution time,nutritional status,feeding related complications and feeding intolerance rate were compared between the two groups．Results Compared with the reference group,the time of clinical symptoms resolution in the observation group was shorter（P<0.05）,and the body mass index,upper arm muscle circumference,triceps skin fold thickness and serum albumin level in the observation group were higher（P<0.05）．The feeding-related complications of the two groups mainly included nausea and vomiting,aspiration,diarrhea and infection．The incidence of feeding-related complications in the observation group was 7.50%,and that in the reference group was 25.00%．The incidence of feeding-related complications in the observation group was lower（P<0.05）．There were 2 cases of feeding intolerance in the observation group,the feeding intolerance rate was 5.00%,and 9 cases of feeding intolerance in the reference group,the feeding intolerance rate was 22.50%,the feeding intolerance rate in the observation group was lower（P<0.05）．Conclusions Implementing ultra early stepped collaborative nutritional management in patients with severe acute pancreatitis can reduce the incidence of feeding intolerance and feeding related complications,and improve nutritional levels．

目的 观察营养指导联合预防护理在小儿癫痫意外预防中作用。方法 抽取焦作市妇幼保健院2021年1月—2023年1月收治的116例小儿癫痫患儿,按照护理方法分为两组,每组各58例。对照组行常规护理,联合组患儿在常规护理基础上给予营养指导联合预防护理干预,对比两组家属满意度、患儿依从率、蒙特利尔认知评估量表（MoCA）评分。结果 经过护理干预,联合组家属满意率98.28%,依从率96.55%,比对照组87.93%、82.76%高（P<0.05）;住院至出院居家三个月内,相较于对照组,联合组患儿外伤发生次数、发病持续时间、癫痫发作次数较少（P<0.05）;护理后,联合组MoCA评分高于对照组（P<0.05）。结论 在小儿癫痫意外预防中联合应用营养指导和预防护理可改善患儿遵医行为,优化小儿癫痫意外预防效果,减少患儿外伤、癫痫发生次数,缩短患儿发病持续时间,提升患儿生活质量和家属满意度。

Objective To observe the effect of nutritional guidance combined with preventive nursing on the prevention of epilepsy accidents in children．Methods A total of 116 cases of pediatric epilepsy admitted in Jiaozuo Maternal and Child Health Care Hospital from January 2021 to January 2023 were selected．They were divided into two groups according to the nursing method,with 58 cases in each group．The control group was given usual care,while the combined group was given nutritional guidance combined preventive nursing intervention．The satisfaction,the compliance rate and MoCA score were compared between two groups．Results After nursing intervention,the satisfaction rate of the combined group was 98.28%,and the compliance rate of the combined group was 96.55%,which were higher than 87.93% and 82.76% in the control group（P<0.05）．Within three months from hospitalization to discharge,compared with the control group,number of injuries,duration and frequency of seizures were less in the combined group（P<0.05）．After nursing,the MoCA score of the combined group was higher than that of the control group（P<0.05）．Conclusions The combined application of nutritional guidance and preventive nursing in the prevention of pediatric epileptic accidents can improve the compliance behavior of children,optimize the prevention effect of pediatric epileptic accidents,reduce the incidence of trauma and epilepsy in children,shorten the duration of illness,and improve the quality of life of children and family satisfaction．

目的 探讨个体化肠内营养支持在胃肠术后早期应用的可行性及安全性。方法 选取2022年1月—12月安徽省亳州市中医院普通外科收治的胃肠手术患者100例。使用随机数字表法将患者随机为观察组和对照组,每组各50例。观察组在常规治疗基础上实施个体化肠内营养,持续7 d。对照组则接受术后常规处理。术后第7天测定实验室指标,并比较两组胃肠功能的恢复情况。结果 观察组术后肛门首次排气时间短于对照组[（55.41±19.63）h vs （81.46±19.39） h],前白蛋白水平高于对照组[（241.14±65.73）g/L vs（217.35±51.63）g/L],组间比较差异有统计学意义（P<0.05）。血清总蛋白水平[（70.55±18.89）g/L vs （68.16±20.05）g/L]、血清白蛋白水平[（53.22±17.76）g/L vs（50.76±18.54）g/L]、淋巴细胞计数[（1.60±0.54）×10⁹/L vs （1.56±0.55）×10⁹/L]以及肛门排便时间[（89.67±22.31）h vs （97.77±21.27）h ]在组间比较差异无统计学意义（P>0.05）。结论 根据个体情况在胃肠术后早期实施个体化的肠内营养支持是安全可行的,能够促进胃肠功能的快速恢复,从而改善患者的营养状况。

Objective To investigate the feasibility and safety of personalized enteral nutrition support during the early postoperative period of gastrointestinal surgery．Methods A total of 100 patients who underwent gastrointestinal surgery at the Department of General Surgery,Bozhou Hospital of Traditional Chinese Medicine,who were enrolled in this study during January 2022 to December 2022．Patients were randomly allocated into either the observational or control group,with 50 patients in each group．The randomization was performed using a random number table．The observational group received personalized enteral nutrition support in addition to routine treatment for 7 days．The control group received standard postoperative care．Laboratory indicators were measured on the 7th postoperative day to compare recovery of gastrointestinal function between the two groups．Results The observational group exhibited a significantly shorter time to the first passage of flatus from the anus compared to the control group（55.41±19.63 h vs 81.46±19.39 h,P<0.05）,as well as higher prealbumin levels（241.14±65.73 g/L vs 217.35±51.63 g/L,P<0.05）．However,there were no significant differences between the two groups in terms of serum total protein levels（70.55±18.89 g/L vs 68.16±20.05 g/L）,serum albumin levels（53.22±17.76 g/L vs 50.76±18.54 g/L）,lymphocyte counts[（1.60±0.54）×10⁹/L vs （1.56±0.55）×10⁹/L],and time to the first defecation from the anus（89.67±22.31 h vs 97.77±21.27 h）（all P>0.05）．Conclusions Personalized enteral nutrition support based on individual conditions is safe and feasible in the early postoperative period of gastrointestinal surgery．It can promote the rapid recovery of gastrointestinal function and improve patients' nutritional status．