外科患者的营养风险和营养不良发生率是影响手术预后和康复进程的关键因素。 大量研究证实,对于术前存在营 养风险和营养不良的外科患者,及时制订营养治疗计划和规范实施,是减少术后并发症的重要举措。 全程营养管理贯穿于术 前、术后及出院后各个阶段,其核心要点包括营养筛查、评估、诊断、干预和监测五大环节,通过建立以外科医师为首的多学科 营养治疗团队,针对外科患者围手术期不同阶段的代谢特点,规范进行营养诊疗。 本文结合目前国内外科营养管理现状,重 点讨论术前预康复、术后早期肠内营养和出院后口服营养补充等全程营养管理中的要点问题,以期促进术后康复过程。 然 而,在全程营养管理的实施过程中,仍面临人力资源不足、专业培训滞后、缺乏标准化流程及政策支持等难点,制约了其广泛 推广和规范应用。 未来,随着各级医疗机构的重视,依托临床营养专家和专业学/ 协会的指导,强化学科建设与多学科协 作,有望推动全程营养管理的深入发展,为外科患者的快速康复提供更为精准和高效的营养治疗,不断提升医疗质量和优化 卫生经济学效益。

The incidence rates of nutritional risk and malnutrition among surgical patients are relatively high which are key factors affecting the surgical prognosis and the rehabilitation process. A large number of studies have confirmed that for surgical patients with nutritional risk and malnutrition before surgery formulating a nutritional support treatment plan in a timely manner and implementing it in a standardized way are important measures to reduce postoperative complications. Whole-course nutritional management runs through all stages before surgery after surgery and after discharge. Its core elements include five links nutritional screening assessment diagnosis intervention and monitoring. By establishing a multidisciplinary nutritional support treatment team led by surgeons nutritional diagnosis and treatment are carried out in a standardized manner according to the metabolic characteristics of surgical patients at different stages of the perioperative period. Combining with the current status of surgical nutritional management in China this article focuses on discussing key issues in whole -course nutritional management such as prehabilitation before surgery early enteral nutrition after surgery and oral nutritional supplementation after discharge with a view to promoting the postoperative rehabilitation process. However in the implementation process of whole-course nutritional management there are still difficulties such as insufficient human resources lagging professional training lack of standardized processes and policy support which restrict its widespread promotion and standardized application. In the future with the increasing attention paid by medical institutions at all levels relying on the guidance of clinical nutrition experts and professional societies and strengthening discipline construction and multidisciplinary collaboration it is expected to promote the in-depth development of whole-course nutritional management provide more precise and efficient nutritional support treatment for the rapid rehabilitation of surgical patients continuously improve the quality of medical care and optimize the health economic benefits.