集束化管理策略在鼻咽癌调强适形放射治疗患者营养干预中的研究  

Research on Cluster Management in Nutritional Intervention for Nasopharynx Cancer Patients Undergoing Intensity Modulated Radiation Therapy

作　　者：韦燕萍[1] 陈柳云[2] 吴庆珍[3] 杜江[3] 

机构地区：[1]广西科技大学第二附属医院门诊部,广西柳州545006 [2]广西科技大学第二附属医院营养科,广西柳州545006 [3]广西科技大学第二附属医院放射治疗科,广西柳州545006

出　　处：《华西医学》2016年第7期1258-1261,共4页West China Medical Journal

基　　金：广西壮族自治区卫生厅计划课题(Z2013147)~~

摘　　要：目的 研究集束化营养干预模式对鼻咽癌调强适形放射治疗（放疗）患者的影响，探讨有效可行的营养管理方法。方法 选择 2013 年 6 月－ 2014 年 12 月入住放疗科行调强适形放疗的鼻咽癌患者 83 例，通过随机数表法分为干预组（42 例）及对照组（41 例）。干预组采用营养风险筛查 2002（NRS-2002）营养筛查、营养评估、实施个体化的全程营养干预模式，对照组实施常规健康教育与营养指导，观察并记录两组患者干预前后的营养风险、营养状态及放疗副反应情况，进行比较与评价。结果 干预后，干预组 NRS-2002 评分显著低于对照组（P＜ 0.05），体质量、体质量指数、三头肌皮褶厚度、上臂围和上臂肌围与对照组比较差异有统计学意义（P ＜ 0.05），血清总蛋白、血清白蛋白、血清运铁蛋白均优于对照组（P ＜ 0.05），Ⅲ ～ Ⅳ级放射性口腔黏膜炎发生率低于对照组（P＜ 0.05）。结论 集束化营养干预模式能有效改善鼻咽癌调强适形放疗患者营养状况，降低营养不良风险，减轻放疗不良反应，促进肿瘤康复。Objective To research on the influence of cluster management on the nutritional intervention for nasopharynx cancer patients undergoing intensity modulated radiation therapy（IMRT）,in order to discuss effective and feasible nutrition management method.Methods Eighty-three nasopharynx cancer patients undergoing IMRT between June 2013 and December 2014 were selected as the study subjects.They were divided into two groups randomly.Regular health education and nutritional guidance were carried out for the 41 patients in the control group,while nutritional risk screening（NRS）-2002 nutrition screening,nutrition assessment and nutritional intervention were carried out for the 42 patients in the intervention group.Nutrition risk,nutritional status and side-reaction were recorded and evaluated for both groups of patients.Results After treatment,NRS-2002 score of the intervention group was lower than the control group（P〈 0.05）.Body weight,constitutional index,skinfold thickness of triceps brachii muscle,mid-arm circumference and mid-arm muscle circumference of the intervention group were better than the control group（P〈 0.05）.Total serum protein,serum albumin,serum transferrin were better and the rate of level Ⅲ-Ⅳ radiation-induced oral mucositis was lower in the intervention group than that in the control group（P〈 0.05）.Conclusion The application of cluster management model in nutritional intervention is a way to promote patients＇ rehabilitation,which can effectively improve the whole body situation of nasopharynx cancer patients,and reduce malnutrition rate and side-reaction.

关 键 词：营养干预 集束化管理 鼻咽癌 放射治疗 

分 类 号：R473.73[医药卫生—护理学]