体质量指数在乳腺癌患者确诊后变化趋势的纵向研究  

Dynamic BMI Changes in Patients Diagnosed with Breast Cancer:A Longitudinal Study

作　　者：奚凯雯 吴莉萍[2] 刘新义 吴怡颖[3] 方琼[3,4] XI Kaiwen;WU Liping;LIU Xinyi;WU Yiying;FANG Qiong(School of Nursing,Shanghai Jiao Tong University,Shanghai 200025,China;Department of Surgery,Ruijin Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 200025,China;Dmprehensive Breast Health Center.Ruijin Hospital,Shanghai Jiao Tong University School of Medicine;Department of Nursing,Ruijin Hospital,Shanghai Jiao Tbng University School of Medicine)

机构地区：[1]上海交通大学护理学院,上海200025 [2]上海交通大学医学院附属瑞金医院手术室,上海200025 [3]上海交通大学医学院附属瑞金医院乳腺疾病诊治中心,上海200025 [4]上海交通大学医学院附属瑞金医院护理部,上海200025

出　　处：《解放军护理杂志》2019年第12期1-4,共4页Nursing Journal of Chinese People's Liberation Army

基　　金：上海交通大学医学院附属瑞金医院护理科研项目(RJHQ-2015-9);上海市科学技术委员会生物医药重点项目(16411951100)

摘　　要：目的探索乳腺癌患者确诊后体质量指数(body mass index,BMI)的变化趋势。方法2016年8-11月,方便抽样法选取上海市某三级甲等综合性医院乳腺外科的160例乳腺癌女性患者为研究对象,分别于诊断时至术后15个月内的10个时间点测量并计算BMI指数,分析患者人口学及疾病资料对BMI总体水平的影响。结果本组31.88%(51例)的乳腺癌患者诊断时存在超重或肥胖;随着治疗的进展,患者在术后6个月平均BMI达到最高峰,术后15个月平均BMI有所回落,但依旧高于诊断时基线水平;术后15个月有36.25%(58例)出现BMI增加,8.75%(14例)为显著增加(≥2 kg/m^2)。单因素分析显示:40岁以上、小学及以下学历、月均收入低于5000元、绝经后、退休或无业以及诊断期为超重或肥胖者在乳腺癌治疗期间(15个月内)BMI始终处于较高水平;多因素分析结果显示:未罹患合并症、年龄超过60岁以及接受化疗患者是发生治疗期间体质量增加的高危人群。结论乳腺癌患者确诊时超重及肥胖占比较高,伴随诊治过程BMI呈现增长趋势,识别BMI增加的危险因素可为乳腺癌患者个体化体质量管理的实施提供依据。Objective To explore the Body Mass Index(BMI)changes in breast cancer patients after diagnosis.Methods Using the convenience sampling method,160 women with breast cancer in the hospital from August to November 2016 were recruited.The patients’BMI was measured and calculated at 10-time points from diagnosis to 15 months after the operation.Analysis the impact of demographic and disease data on the overall tendency of BMI.Results Totally 31.88%(51 cases)of breast cancer patients were overweight or obese at diagnosis.With the progress of breast cancer treatment,patients’weight showed a significant upward trend in the first six months during the postoperative period,and it started to fall back afterward.Despite this,the BMI index at 15 th months was still significantly higher than the baseline level.In contrast to the preoperative status,patients with BMI increase accounted for 36.25%(58 cases),and those with more than 2.0 kg/m^2 increase accounted for 8.75%(14 cases).Univariate analysis showed that those over 40 years old,postmenopausal,retired or unemployed,with an elementary school education or below,with a monthly income of less than 5000 yuan and those were overweight or obese at diagnosis were generally at a higher level during the treatment period(15 months after diagnosis).Multivariate analysis showed that different age,comorbidities,surgery procedures,and chemotherapy were the key factors for weight gain during treatment.Conclusions Overweight and obesity account for a relatively high proportion of breast cancer patients at the time of diagnosis and BMI presents a significant increase trend during the treatment.The identification of risk groups with high BMI and risk factors for BMI increase could assist oncology nurses to implement individualized weight management for breast cancer patients.

关 键 词：乳腺癌 体质量指数 肥胖 体质量增加 

分 类 号：R473.73[医药卫生—护理学]