Construction Of Nutritional Management Program Of Postoperative Chemotherapy Patients With Colorectal Cancer Based On Evidence

Objective:To construct a systematic,scientific and standard nutritional management program of postoperative chemotherapy patients with colorectal cancer,so as to improve the nutritional status of patients with postoperative chemotherapy for colorectal cancer,and to provide reference for subsequent clinical practice and popularization.Methods:Firstly,we set up a program team,searched the domestic and foreign research systematically on nutrition management in patients with postoperative chemotherapy for colorectal cancer.Secondly,through the selection of literature,data extraction,quality evaluation,classification of evidence,we summarized the evidence of recent studies on nutrition management of postoperative chemotherapy patients with colorectal cancer at home and abroad.The preliminary nutritional management program of postoperative chemotherapy for patients with colorectal cancer was drawn up.Finally,a total of 20 experts in related fields were selected for consultation based on the Delphi method,and the results of consultation were analyzed and demonstrated,so as to finally construct the nutritional management program of postoperative chemotherapy for patients with colorectal cancer.Results:Through the preliminary search,a total of 2384 articles were obtained.After elimination of repeated screening,preliminary screening and rescreening,31 articles were retained,including 6clinical guidelines,6 randomized controlled trials,12 quasi-experimental research,1 observational study,3 systematic evaluations,and 3 expert group consensus.Through the summary of evidence,drawn up a preliminary program contains 5 level Ⅰ items,22 level Ⅱ items and 42 level Ⅲ items.The questionnaire recovery efficiency of the two rounds of expert consultation is 95% and 100%,the coefficients of expert authority are 0.81 and 0.83,respectively.The coefficient of variation of the importance of items in the two rounds of correspondence inquiry is between 0.06-0.29,and the coefficient of variation of the operability of items is between 0.06-0.33.The coordination coefficient of the expert opinions on the importance of items in the two rounds of correspondence consultation is between 0.138-0.225,and the coordination coefficient of the expert opinions on the operability of items is between 0.110-0.141,both P values are less than 0.001.In the first round,11 items were adjusted,3 items were deleted,and 2 items were adjusted in the second round by summarizing expert suggestions.We finally constructed the program,including 5 level Ⅰ items,22 level Ⅱ items and 40 level Ⅲ items.Conclusion:The study constructed a nutritional management program of postoperative chemotherapy for patients with colorectal cancer,including nutrition screening and assessment,nutrient demand,nutritional support,evaluation and education,and other measures.The process of solution construction is rigorous and standard,and the results are scientific and reliable.The program clarified the content of nutrition management for patients with postoperative chemotherapy for colorectal cancer,provided evidence support for nutrition management,and provided theoretical basis for further clinical application and promotion.