胃癌根治术后患者化疗期营养风险的动态评估及饮食指导启示  

Nutritional risk assessment and inspiration for patients in chemotherapy after radical gastrectomy

作　　者：屈清荣[1] 杨程舒 何卫芳[2] 徐一格 

机构地区：[1]郑州大学第一附属医院护理部,450052 [2]郑州大学第一附属医院胃肠外科,450052

出　　处：《中国实用护理杂志》2017年第16期1201-1204,共4页Chinese Journal of Practical Nursing

摘　　要：目的 调查胃癌根治术后患者化疗期的营养状况,为患者提供及时有效的饮食指导提供依据.方法 选取2014年9月至2016年3月在郑州大学第一附属医院胃肠外科行胃癌根治性切除术后接受完整化疗的患者,每次化疗入院后48 h内进行营养状况相关评估,填写患者主观整体营养状况评量表,化疗结束后填写胃癌患者化疗不良反应调查问卷,对化疗期患者化疗初期、化疗中期、化疗结束时进行动态营养评估.结果 患者化疗不同阶段的营养风险评估得分分别为（6.107±2.947）、（6.505±3.134）、（8.068±3.748）分,差异有统计学意义（F=10.202,P〈0.01）;食欲减退是发生率最高的化疗不良反应,化疗前期、中期、后期的发生率分别为34.95%（36/103）、56.31%（58/103）、75.73%（78/103）;患者获取饮食知识的途径主要为医护人员,化疗前期、中期、后期所占比例分别为92.23%（95/103）、79.61%（82/103）、75.73%（78/103）.结论 胃癌根治术后患者随着化疗进行营养状况越来越差,建议医护人员针对患者的营养状况及时给予饮食指导,改善患者的营养状况,提高疾病预后.Objective To investigate the nutritional status of patients with chemotherapy after radical gastrectomy and to provide dietary guidance and nutritional support for patients in time. Methods Patients who received chamotherary after radical gastrectomy inthe Gastrointestinal Surgery of the First Affiliated Hospital of Zhengzhou University from September 2014 to March 2016 were included in the study. The nutritional status was assessed by unified training investigators within 48 h after hospitalization. The questionnaires of Scored Patient-Generated Subjective Global Assessment （PG-SGA） and the Chemotherapy Side Effects of Patients with Gastric Cancer Questionnaire were used to investigatethe patients by trained investigators. Results The scores of the nutritional status of patients with different stages of chemotherapy were 6.107±2.947, 6.505 ±3.134, 8.068 ±3.748, which was statistically significant （F=10.202, P〈0.01）. The incidence of anorexia was the highest rate of diet-related symptoms, the rate of early, mid-term and later chemotherapy rates were 34.95%（36/103）, 56.31%（58/103）, and 75.73%（78/103） respectively. Patients acquired the diet knowledge mainly from medical staff. The proportions of early, middle and later stages of chemotherapy were 92.23% （95/103）, 79.61% （82/103）, 75.73%（78/103）. Conclusions With the increase of chemotherapy times, the nutritional status of patients with radical gastrectomy is getting worse. The results suggested that medical staff should provide an effective basis dietary guidance in time, improving the patients′nutritional status and clinical outcomes.

关 键 词：药物疗法 联合 胃癌根治术 营养评估 饮食指导 

分 类 号：R473.73[医药卫生—护理学]