PG-SGA在常见消化道恶性肿瘤患者中的应用研究  

Application of PG-SGA in patients with common gastrointestinal tumors

作　　者：杨家君[1] 黄学军[1] 邓俊晖[1] 黄稳达 周雄[1] 石汉平[2] YANG Jia-jun HUANG Xue-jun DENG Jun-hui HUANG Wen-da ZHOU Xiong SHI Han-ping(Department of Colorectal and Annal Surgery, Huizhou Municipal Central Hospital, Huizhou 516001, Guangdong, China Department of General Surgery/Medical Oncology Center, Aviation General Hospital/Beijing Institute of Translational Medicine, Chinese Academy of Sciences, Beijing 10012, China)

机构地区：[1]惠州市中心人民医院肛肠外科,广东惠州516001 [2]中国科学院北京转化医学研究院/航空总医院肿瘤医学中心/普外科,北京100012

出　　处：《肿瘤代谢与营养电子杂志》2017年第2期189-193,共5页Electronic Journal of Metabolism and Nutrition of Cancer

基　　金：国家重点研发计划项目"恶性肿瘤姑息治疗和护理关键技术研究"(2017YFC1309200);广东省惠州市科技计划项目(2016Y010)

摘　　要：目的利用PG-SGA对常见消化道恶性肿瘤患者的营养状况进行研究分析。方法把2015年5月至2016年5月在惠州市中心人民医院住院的常见消化道恶性肿瘤患者纳入研究,共304例,包括食管癌、胃癌、大肠癌(结肠癌、直肠癌),病理结果诊断明确,自愿入选本研究。按照入院目的分为放化疗患者、手术治疗患者、并发症治疗患者。所有患者入院24小时内,由经过正规培训的同一名外科医师采用统一询问方式,对符合条件的调查对象分别应用PG-SGA进行营养诊断。PG-SGA评分≥4诊断为存在营养不良,PG-SGA评分≥9诊断为严重营养不良,分析食管癌、胃癌、大肠癌的营养不良发生情况。结果所有参与研究的304例患者中,营养不良发生率为80.6%,重度营养不良发生率为34.2%,手术治疗患者营养不良和重度营养不良的发生率高于放化疗患者,上消化道恶性肿瘤患者营养不良发生率高于下消化道恶性肿瘤患者,荷瘤患者营养不良发生率高于非荷瘤患者,差异均有统计学意义;PG-SGA评分与肿瘤TNM病理分期呈显著正相关,肿瘤分期越晚期,PG-SGA评分越高;有营养不良患者的住院天数和住院总费用均高于无营养不良患者,差异均有统计学意义。结论常见消化道恶性肿瘤患者的营养不良发生率较高,需重视消化道恶性肿瘤患者的营养评估和营养治疗;PG-SGA可以较好地反映常见消化道恶性肿瘤患者的营养状况,而且能够预测患者的肿瘤分期、住院时间及住院费用;去除肿瘤是改善消化道肿瘤患者营养状况的一个有效手段。Objective To evaluate the use of the patient-generated subjective global assessment （PG-SGA） for the assessment of nutritional status in patients with gastrointestinal tumors. Methods 304 patients hospitalized in Huizhou Municipal Central Hospital from May 2015 to May 2016 were enrolled. The diagnosis with gastrointestinal tumors was confrmed by pathological examination and patients received chemotherapy/radiotherapy or surgery or treatment for complication. The patients were interviewed by a trained surgeon using PG-SGA within 24 hours after admission. PG-SGA score ≥ 4 indicated malnutrition. PG-SGA score ≥ 9 indicated serious malnutrition. Results 304 patients participated in this study, 80.6% of the patients’ had PG-SGA score ≥ 4, 34.2% of the patients’ had PG-SGA score ≥ 9. The incidence of malnutrition in the patients received surgery is higher than patients received chemotherapy/radiotherapy, the incidence of malnutrition in the patients with upper gastrointestinal cancer is higher than the patients with lower gastrointestinal cancer, the incidence of malnutrition in the patients of bearing cancer is higher than patients of unbearing cancer. The difference are signifcant. The correlation between the scores of PG-SGA and the TNM pathological stage is positive; the later stage, the more scores of PG-SGA assessment. The length of hospital stay and the hospitalization costs between patients with and without malnutrition are signifcant different. Conclusions The incidence of malnutrition in the patients of gastrointestinal tumors is high, we should pay attention to the nutrition assessment and nutrition therapy for these patients. PG-SGA is an appreciated tool for nutritional assessment for patients with gastrointestinal tumors. It can predict the clinical stage, the length of hospital stay and the hospitalization costs. Remove the tumor from the patient is an effect way to improve the nutritional status of the patients with gastrointestinal tumors.

关 键 词：PG-SGA 恶性肿瘤 营养评估 

分 类 号：R459.3[医药卫生—治疗学] R735[医药卫生—临床医学]