重庆市某医院常见恶性肿瘤住院患者营养状况调查  

Nutritional status assessment for patients with common cancer in a hospital of Chongqing

作　　者：贺英[1,2] 林欣[1] 刘莉 王佳佳[1] 宋春花[3] 石汉平[4] 许红霞[1] 常见恶性肿瘤营养状况与临床结局相关性研究(INSCOC)课题组 XU Hong-xia;LIN Xin;WANG Jia-jia;HE Ying;LIU Li;SONG Chun-hua;SHI Han-ping(Department of Nutrition, Daping Hospital & Research Institute of Surgery, Third Military Medical University, Chongqing 400042,China;Department of Nutrition, Chongqing General Hospital, Chongqing 400014, China;Department of Epidemiology, College of Public Health, Zhengzhou University, Zhengzhou 450001, China;Department of General Surgery, Aviation General Hospital/Beijing Institute of Translational Medicine, Chinese Academy of Sciences, Beijing 10012, China)

机构地区：[1]第三军医大学大坪医院临床营养科,重庆400042 [2]重庆市人民医院临床营养科,重庆400014 [3]郑州大学公共卫生学院流行病学教研室,郑州450001 [4]中国科学院北京转化医学研究院/航空总医院普外科,北京100012 [5]不详

出　　处：《肿瘤代谢与营养电子杂志》2017年第1期45-50,共6页Electronic Journal of Metabolism and Nutrition of Cancer

基　　金：国家自然科学基金(81673167);重庆市医学重点学科建设项目(2012);第三军医大学大坪医院临床科研课题(2014YLC08)

摘　　要：目的调查重庆市人民医院常见恶性肿瘤住院患者的营养状况。方法采用营养风险筛2002、PG-SGA、体格测量、实验室检测等方法对重庆市人民医院自2015年5月4日至2015年12月31日的311例16种常见恶性肿瘤住院患者进行营养风险筛查、营养评估,并调查这些患者的营养治疗情况。结果 311例患者中,有营养风险(NRS 2002≥3分)的为44.37%(138/311)。以PG-SGA评分评估患者营养状况,结果显示,52.73%(164/311)的肿瘤患者存在中度营养不良(PG-SGA≥4分),其中31.19%(97/311)为重度营养不良(PG-SGA≥9分);消化道肿瘤患者营养不良的发生率比非消化道肿瘤患者高(65.41%vs.43.26%,χ~2=13.417,P<0.001);多元线性回归分析体质指数、血清白蛋白、血清前白蛋白、最近1个月体重下降百分比、左小腿围、非利手握力与PG-SGA评分之间有相关性(P均<0.001),其中左小腿围、最近1个月体重下降百分比与PG-SGA评分相关性最好(回归系数B分别为-0.872、0.861,P<0.001),血红蛋白、上臂肌围与PG-SGA评分相关性不具统计学意义(P分别为0.268,0.218);中、重度营养不良患者的营养治疗率仅为43.90%(72/164),营养治疗以单独肠外营养治疗为主,占91.7%(66/72),肠内营养联合肠外营养占6.94%(5/72),单独肠内营养治疗仅1例,占营养治疗患者的1.38%(1/72)。结论 52.73%的常见恶性肿瘤患者存在中、重度营养不良。PG-SGA评分是评估肿瘤患者营养不良简便、有效的工具,营养不良的患者营养治疗率低,且以肠外营养为主,肠内营养治疗率极低。建议对恶性肿瘤患者进行入院后的营养风险筛查以及包括PG-SGA评分在内的全面营养评估,并给予正确的营养治疗。Objective To investigate the nutritional status of hospitalized patients with common malignant tumor in Chongqing General Hospital.Methods From May4th2015to Dec31st2015,we enrolled311patients with cancer hospitalized for treatment in Chongqing General Hospital.These patients were diagnosed with one of the following16different types of malignant tumors:lung cancer,gastric cancer,liver cancer,colorectal cancer,breast cancer,esophageal cancer,cervical cancer,endometrial cancer,nasopharyngeal carcinoma,malignant lymphoma,leukemia,pancreatic cancer,ovarian cancer,prostate cancer,bladder cancer andbrain tumor.Nutritional risk screening2002(NRS2002),patient-generated subjective global assessment(PG-SGA),anthropometricmeasurements,and laboratory examination were used to evaluate the nutritional risk or nutritional status.We also investigated thenutritional therapy of these cancer patients.Results According to the NRS2002score,138patients(44.37%)had the nutritional risk(score≥3);With PG-SGA score as standard,52.73%(164/311)of the cancer patients were malnutrition(PG-SGA≥4),and31.19%(97/311)were severe malnutrition(PG-SGA≥9).The rate of malnutrition for gastrointestinal cancer patients is higher than Nongastrointestinalcancer patients(65.41%vs.43.26%,χ2=13.417,P<0.001).Multiple linear regression analysis,PG-SGA scoresand body mass index(P<0.001),serum albumin(P<0.001),prealbumin(P<0.001),the percentage of weight loss in the recent1month(P<0.001),calf circumference(left side,P=0.001),non-profit grip strength(P=0.001)were correlated,in which left calfcircumference,last1month weight loss percentage correlation with PG-SGA scoring the best(regression coefficient b-0.872,0.861,P<0.001,respectively),hemoglobin,arm muscle circumference and PG-SGA scores correlated without statistical significance(P,0.268,0.218,respectively);43.90%(72/164)of all the moderately and severely malnourished patients received nutritional the rapy,91.7%(66/72)were receive only parenteral nutrition,6.94%(5/72)were received enteral and parenteral nu

关 键 词：恶性肿瘤 营养风险筛查 营养评估 PG-SGA 营养治疗 

分 类 号：R73-31[医药卫生—肿瘤] R459.3[医药卫生—临床医学]