老年食管癌患者放疗期营养状况分析  

Nutritional assessment in elderly patients with esophageal cancer

作　　者：叶英俊[1] 谢淑萍[1] 

机构地区：[1]浙江省肿瘤医院胸部放疗科,杭州310022

出　　处：《中华现代护理杂志》2016年第1期55-58,共4页Chinese Journal of Modern Nursing

基　　金：基金项目：浙江省医药卫生科技计划项目（2012KYA024）

摘　　要：目的分析老年食管癌患者放疗期间的营养风险和营养状况，为临床在选择营养评估工具及营养干预上提供依据。方法选择浙江省肿瘤医院2012年6月-2013年8月65例，年龄≥60岁，行放射治疗的老年食管癌住院患者；分别运用人体测量指标对患者放疗开始、放疗后每周进行营养评估，运用欧洲营养风险筛查工具（NRS2002）每周对患者进行营养风险筛查，并回顾性分析65例患者在院期间营养支持情况。结果与放疗前相比，老年食管癌患者营养风险及各营养评估指标开始出现差异的时间分别是NItS2002，第2周[（2．34±1．24）比（2．09±1．28）；z=3．234，P〈0．01]；体质指数（BMI）：第2周[（20．21±3．03）比（20．51±3．06）；t=3．626，P〈0．01）]；AC：第3周[（24．69±2．87）比（24．96±2．93）；t=2．456，P〈0．05）]；三头肌皮折厚度（TSF）各时间点差异无统计学意义（P〉0．05）；上臂肌围（AMC）差异无统计学意义（P〉0．05）。放疗开始后营养不良风险发生率为33．8％-49．2％；放疗过程中，NSR2002评分与BMI、TSF、AC、AMC呈负相关；营养支持率93．8％（62例），其中肠内营养支持（EN）3例（4．8％），肠外营养支持（PN）59例（95．2％）。结论老年食管癌患者放疗期间营养不良风险较高，且营养状况逐渐下降。NRS2002作为营养风险筛查工具能准确的做出判断，为临床营养干预提供合理依据。Objective To evaluate the nutritional status and risks in elderly patients with esophageal cancer during their radiotherapy; to provide the evidence of nutritional assessment tools and interventions in clinical practice. Methods This retrospective study investigated 65 patients with esophageal cancer （ 〉60 years） who had undergone radiotherapy in Zhejiang Cancer Hospital from June 2012 to August 2013. Nutritional status was assessed at the beginning and after the radiotherapy in every week; nutritional risks were screened every week with the help of NRS 2002. Results Compared with the status at the beginning of radiotherapy, the significant higher nutritional risk emerged： in the second week of the radiotherapy with NRS2002 [ （2.34 ± 1.24） vs （2.09 ±1. 28 ） ; Z = 3. 234, P 〈 0.01 ] ; the second week with body mass index （BMI） [ （20.21 ± 3.03） vs （ 20.51 ± 3.06） ; t = 3. 626, P 〈 0.01 ] ; the third Week with arm circumference （AC） [ （24.69 ± 2.87） vs （24.96 ± 2.93 ） ; t = 2. 456, P 〈 0.05 ]. The differences of triceps skinfold （TSF） and arm muscle circumference （AMC） had no significance （P 〉0.05）. The incidence of malnutrition during radiotherapy was 33.8% -49.2%; the score of NRS2002 was negatively correlated with BMI, TSF, AC and AMC. Nutritional support were provided to 62（93.8% ）patients, three （4.8%） of the patients received enteral nutrition （ EN ）, 59 （95.2%） patients received parenteral nutrition （ PN ）. Conclusions The risk of malnutrition is high in elderly patients with esophageal cancer and will even worse with the process of radiotherapy. NRS2002 can precisely detect nutritional risks and provide the evidence of nutritional interventions in clinical practice.

关 键 词：食管肿瘤 放射疗法 营养评价 老年人 

分 类 号：R473.73[医药卫生—护理学]