全程营养管理在围手术期患者的应用中具有重要意义。 围手术期涵盖术前、术后及出院后 30 d 内 3 个阶段,全程 营养管理通过系统化、动态化、个体化的精准营养干预策略,全面优化患者的营养状态。 研究表明,营养状态直接影响患者的 术后预后、康复进程及长期生存质量。 术前阶段,通过标准化筛查工具识别营养风险与营养不良患者,并实施至少 7 d 的营养 治疗,可显著改善低蛋白血症、降低术后感染率及提高生存率。 对于消化道手术患者,术前以肠内营养替代传统肠道准备可 减少肠黏膜损伤,同时维持营养状态。 术后阶段,早期启动肠内营养可加速肠道功能恢复,缩短住院时间,并降低感染风险; 对于肠道功能受限患者,补充性肠外营养在确保能量与蛋白质摄入的同时需避免代谢并发症。 出院后 30 d 内,患者仍面临营 养不良风险,尤其需重视口服营养补充的持续应用,其可有效减少骨骼肌流失、改善化疗耐受性,并通过远程监测与数字化工 具提升依从性。 然而,当前临床实践中仍存在营养筛查工具应用不统一、干预措施规范化不足、特殊患者群体支持时机不明 确等问题。 本文基于文献检索策略,系统阐述了围手术期全程营养管理的最新研究进展,旨在为临床医师提供多学科协作的 个体化管理框架,优化营养治疗策略,最终降低并发症发生率、缩短康复周期,并提高患者生活质量。

The application of comprehensive nutrition management in perioperative patients is of great significance. The perioperative period covers three stages pre - operation post - operation and the 30 days after discharge. Through systematic dynamic and individualized precise nutrition intervention strategies comprehensive nutrition management comprehensively optimizes the nutritional status of patients. Research shows that the nutritional status directly affects the postoperative prognosis rehabilitation process and long-term quality of life of patients. In the pre-operative stage identifying patients with nutritional risks and malnutrition through standardized screening tools and implementing nutritional support for at least 7 days can significantly improve hypoproteinemia reduce the postoperative infection rate and increase the survival rate. For patients undergoing gastrointestinal surgery replacing traditional bowel preparation with enteral nutrition before surgery can reduce intestinal mucosal damage while maintaining nutritional status. In the postoperative stage the early initiation of enteral nutrition can accelerate the recovery of intestinal function shorten the length of hospital stay and reduce the risk of infection. For patients with limited intestinal function supplemental parenteral nutrition is required to ensure energy and protein intake while avoiding metabolic complications. Within 30 days after discharge patients still face the risk of malnutrition. In particular the continuous application of oral nutritional supplements needs to be emphasized. It can effectively reduce skeletal muscle loss improve the tolerance to chemotherapy and enhance compliance through remote monitoring and digital tools. However in current clinical practice there are still problems such as the inconsistent application of nutritional screening tools insufficient standardization of intervention measures and unclear timing of support for special patient groups. Based on the literature retrieval strategy this article systematically reviews the latest research progress of comprehensive nutrition management during the perioperative period including nutritional screening criteria intervention programs implementation paths and health economic benefits. It aims to provide clinicians with an individualized management framework for multidisciplinary collaboration optimize nutritional support strategies ultimately reduce the incidence of complications shorten the rehabilitation period and improve the quality of life of patients.