结直肠癌患者术前营养状况对术后生活质量影响  

The effect preoperative nutritional risk screening on postoperative quality of life in colorectal cancer patients

作　　者：严荣燚[1] 李梅[1] 朱凌燕[1] 丁飚[1] YAN Rong-yi;LI Mei;ZHU Ling-yan;DING Biao(Nursing Department,Shanghai Jiao Tong University Affiliated Sixth People's Hospital,Shanghai 200233,China)

机构地区：[1]上海交通大学附属第六人民医院护理部,上海200233

出　　处：《肿瘤代谢与营养电子杂志》2018年第2期189-193,共5页Electronic Journal of Metabolism and Nutrition of Cancer

基　　金：上海市第六人民医院院级课题基金(院内-1659)

摘　　要：目的探讨术前营养风险对胃肠肿瘤患者术后生存质量的影响,并对临床营养治疗提出合理建议。方法通过一项回顾性研究,选取2014年6月至2016年6月上海交通大学附属第六人民医院普外科新入院结直肠癌患者150例,入院后24小时内,应用NRS 2002评估其营养状况,根据评分将患者分为两组,即研究组(存在营养风险)和对照组(无营养风险),比较两组患者术后并发症之间的差异,运用欧洲癌症研究与治疗组织的生命质量核心量表比较两组间生存质量差异。结果 NRS 2002结果显示对照组86例(57%),研究组64例(43%)。不同营养状况患者比较,研究组患者术后感染,吻合口瘘的发生率显著高于对照组患者。两者整体生存质量,躯体功能、认知功能、疲乏、失眠差异有统计学意义(P<0.05);而角色功能、情绪功能、社会功能、恶心呕吐、疼痛、气促、食欲丧失、便秘、腹泻、经济困难差异无统计学意义(P>0.05)。通过多元逐步线性回归分析得出术前营养状态可以作为患者术后生活质量的独立影响因素。结论术前存在营养风险的结直肠癌患者,术后并发症显著增加,术后生活质量下降,应加强对术前存在营养风险患者的营养治疗。Objective To investigate the influence of preoperative nutritional rik on the quality of life colorectal cancer of patients,and to provide the strategy of clinical nutritional support therapy.Methods 150 patients with colorectal cancer were selected from June 2014 to June 2016 in the department of general surgery of Shanghai Jiao Tong University Affiliated Sixth People’s Hospital,and no nutritional support treatment was performed within 24 hours after admission.The nutritional status of patients with colorectal cancer was assessed by the European nutritional risk screening scale(NRS-2002).The patients were divided into two groups according to the score,namely,control group(less than 3 points)and study group(greater than or equal to 3 points)to compare the incidence of postoperative complications in two groups.The difference of life quality was compared according to core scale QLQ-C30 of European Research and Treatment and the Organization.Results According to the NRS-2002 score,64 patients were aasigned to study group(43%)and 86 patients were in control group(57%).The incidence of postoperative infection and anastomotic leak were higher in study group than in control group(P<0.05).The significant differences were found in general health status,physical function,conggnitive function,fatigue and insomnia in patients with different nutritional status(P<0.05).But there was no significant differences in social function,emotion function,nausea/vomiting,pain,dyspnea,appetite loss,constipation,diarrhea and financial difficulties(P>0.05).Multiple linear stepwise regression analysis indicated that nutritional status of patients with colorectal cancer was the independent influence factor of life quality.Conclusion Colorectal cancer patients with nutrition risk was closely associated with higher postoperative complications and quality of life declines.Therefore,it is necessary to strengthen preoperative nutrition support therapy in colorectal cancer patients with nutrition risk.

关 键 词：结直肠癌 营养状况 术后并发症 生活质量 

分 类 号：R735.34[医药卫生—肿瘤]