目的 探索胃癌全胃切除患者从入院到出院后采用全程合理的目标营养对患者营养状况及术后康复的影响。方法 成立肿瘤目标营养团队，制定营养质量控制标准，选取目标营养管理实施前半年（2017 年 2 月至2017 年 7 月）胃癌患者 82 例为对照组，实施后半年（2017 年 8 月至 2018 年 1 月）胃癌患者 89 例为试验组。试验组进行规范的入院营养评估、营 养不良三级诊断，根据营养不良的等级及患者病情选择目标营养实施途径，合理选择营养制剂，实施术前、术后、康复期、 出院后的目标营养，定期评价肠内营养疗效，动态调整目标营养。比较两组入院患者的出院体重、白蛋白、血红蛋白、前 白蛋白等的变化情况，第 1 次肛门排气时间，以及平均住院日、术后并发症发生情况。结果 与对照组比较，试验组患者第 一次肛门排气时间（t=2.101，P=0.039）和平均住院时间（z=-2.081，P=0.037）差异有统计学意义，出入院体重差（t=-5.433， P ＜ 0.05）和出院后3 个月的前白蛋白（t=2.561，P=0.014）差异有统计学意义。白蛋白、血红蛋白、淋巴细胞计数变化差 异无统计学意义（P ＞ 0.05）。术后并发症例数分别为 6 和 16，差异有统计学意义（χ2=6.209，P=0.013）。结论 肿瘤目标 营养团队规范的目标营养实施方案是一种可行的肿瘤患者营养落实管理模式，可以改善患者营养状况，加速术后患者康复， 提高患者舒适度及满意度。

Objective To explore the effect of goal-directed nutrition therapy model on the nutritional status and postoperative rehabilitation of gastric cancer patients (total gastrectomy) from admission to discharge. Methods A cancer target nutrition team was established and the quality control standards for nutrition implementation was also developed. 82 gastric cancer patients from February 2017 to July 2017 were included in the control group, and 89 gastric cancer patients from August 2017 to January 2018 were included in the experimental group. Standardized nutrition assessment and malnutrition level 3 diagnosis was performed in experimental group. According to the patient’s condition, we chose the goal-directed nutrition therapy and a reasonable nutritional preparation; Meanwhile, target nutrition was performed in the period of pre-operative, post-operative, rehabilitation and postdischarge. We also need to regularly evaluate the efficacy of enteral nutrition and constantly adjust the target nutrition. In addition, some data on admission and discharge should be compared between the two groups, such as changes in body weight, albumin, hemoglobin, and prealbumin, the first anal exhaust time, average hospital stay and postoperative complications. Results Compared with the control group, the difference in the first anal exhaust time (t=2.101, P=0.039) and in the average hospitalization time (z=-2.081, P=0.037) was statistically significant. The difference in body weight between discharge and admission (t=-5.433, P<0.01) and prealbumin at 3 months after discharge (t=2.561, P=0.014) was statistically significant. In addition, there were no significant differences in the changes of albumin, hemoglobin and lymphocyte counts (P>0.05). The number of postoperative complications were 6 and 16, respectively, and the difference was statistically significant (χ2=6.209, P=0.013). Conclusions The team of goaldirected nutrition therapy model is a feasible nutrition management model for cancer patients, which can improve the nutritional status of patients, accelerate the recovery of postoperative patients, and improve patient comfort and satisfaction.