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首页> 外文期刊>Journal of human nutrition and dietetics >Comparison of a newly established dietetic clinic for upper gastrointestinal malignancy with a general oncology clinic.
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Comparison of a newly established dietetic clinic for upper gastrointestinal malignancy with a general oncology clinic.

机译：新成立的上消化道恶性肿瘤饮食诊所与普通肿瘤诊所的比较。

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Background: Undernutrition in upper gastrointestinal (UGI) malignancy is common. Research shows weight loss to be associated with increased toxicity from chemotherapy and a poorer prognosis (Andreyev et al., 1998). Timely dietetic intervention is therefore pertinent to optimising treatment outcome, particularly when treatment is multimodal and radical. Prior to 2006, all patients with a UGI malignancy who were referred to a dietitian at our NHS Trust were seen in a general oncology dietetic clinic. In response to growing referrals, a dietetic clinic dedicated to UGI malignancy was established in January 2007. This clinic joined the UGI multidisciplinary team (MDT) medical oncology clinics. This review aimed to evaluate the profile of this new clinic in its first year and explore the changes needed to improve the delivery of this new service to patients. Methods: All patients with an UGI malignancy who were booked into this new dietetic UGI oncology clinic were included in the survey. Data were collected retrospectively for the period 1st of January 2006 - 31st December 2007. Clinic lists were identified using the trust patient information management system. This provided the patient's name and hospital identification number, and age. Tumour type attendance, dietary advice and referral source were found using dietetic case notes. This data was analysed using Microsoft Excel and Chi squared analysis. Results: In 2006, 133 appointments were made across 38 clinics for 68 patients with a UGI malignancy and in 2007, 373 appointments were made in 44 clinics for 169 patients. The mean (SD) age was 64 (11) years and 66 (11) years for 2006 and 2007 respectively. Table 1 shows a summary of the clinic characteristics. Discussion: This new clinic has allowed patients to access nutritional advice in outpatients within a service that largely provides ambulatory care at all stages of treatment. The significant increase in referrals from outpatients may suggest nutritional intervention is being provided earlier in the patients' treatment pathway. This new clinic enables patients to visit the dietitian and other MDT member on the same day thus minimising hospital visits which could explain the small although non significant increase in attendance in 2007. The provision of dietetic intervention within an MDT could help to provide more comprehensive care in a single supportive environment which may enhance patient satisfaction. Furthermore, this new clinic supports national recommendations for multidisciplinary working. Conclusion: This analysis shows there are sufficient patient numbers to sustain this specialist clinic. User involvement and measurement of clinical effectiveness could provide useful information to further develop this service. Reference Andreyev, H.J.N., Norman, A.R., Oates, J. & Cunningham, D. (1998) Why do patients with weight loss have a worse outcome when undergoing chemotherapy for gastrointestinal malignancies? Eur. J. Cancer, 34, 503-509.
机译：背景：上消化道（UGI）恶性肿瘤的营养不良很常见。研究表明，体重减轻与化疗毒性增加和预后较差有关（Andreyev等，1998）。因此，及时的饮食干预与优化治疗效果有关，特别是在多模式和彻底治疗的情况下。在2006年之前，所有在我们的NHS Trust被转介为营养师的UGI恶性肿瘤患者都在普通肿瘤饮食诊所就诊。为了应对不断增加的转诊，于2007年1月成立了专门针对UGI恶性肿瘤的饮食诊所。该诊所加入了UGI多学科团队（MDT）的医学肿瘤诊所。这项审查旨在评估新诊所成立第一年的概况，并探讨为改善向患者提供这项新服务所需的变化。方法：将纳入新饮食UGI肿瘤诊所的所有UGI恶性肿瘤患者纳入调查。回顾性收集2006年1月1日至2007年12月31日期间的数据。使用信任患者信息管理系统来确定诊所清单。这提供了患者的姓名，医院识别号和年龄。使用饮食案例记录发现了肿瘤类型的出勤率，饮食建议和转诊来源。使用Microsoft Excel和卡方分析对该数据进行了分析。结果：2006年，在38个诊所中对UGI恶性肿瘤68例患者进行了133次预约;在2007年，在44个诊所中对169例患者进行了373次预约。 2006年和2007年的平均（SD）年龄分别为64（11）岁和66（11）岁。表1总结了临床特征。讨论：这家新诊所允许患者在门诊中获得营养建议，该服务主要在治疗的各个阶段提供门诊护理。门诊病人转诊的显着增加可能表明在患者的治疗途径中较早提供了营养干预。这个新的诊所使患者能够在同一天拜访营养师和其他MDT成员，从而最大程度地减少了医院就诊次数，这可以解释2007年出勤率虽然很小但没有显着增加。在MDT中提供饮食干预措施可以帮助提供更全面的护理在单一支持环境中可以提高患者满意度。此外，这家新诊所支持有关多学科工作的国家建议。结论：该分析表明有足够的患者人数来维持该专科门诊。用户的参与和对临床有效性的衡量可以为进一步开发该服务提供有用的信息。参考文献Andreyev，H.J.N.，Norman，A.R.，Oates，J.和Cunningham，D.（1998）为什么减肥患者在接受胃肠道恶性肿瘤化学疗法时会有更差的结果？欧元。 J.Cancer，34，503-509。

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