握力在晚期肺癌病人营养状况评估中的应用研究  

Study on application of handgrip strength in assessment of nutritional status of patients with advanced lung cancer

作　　者：李黎 卢幻真[1] 丁利萍 李丹 唐淼燕 LI Li;LU Huanzhen;DING Liping;LI Dan;TANG Miaoyan(Ruikang Hospital Affiliated to Guangxi University of Chinese Medicine,Guangxi 530011 China)

机构地区：[1]广西中医药大学附属瑞康医院,广西530011

出　　处：《护理研究》2020年第12期2105-2109,共5页Chinese Nursing Research

基　　金：广西壮族自治区卫生健康委员会课题,编号:Z20190966。

摘　　要：[目的]探讨握力在晚期肺癌病人营养状况评估中的应用价值。[方法]选取2018年8月—2019年8月在南宁市某三级甲等医院肿瘤科住院的晚期肺癌病人112例,进行一般资料收集、营养状况评估及握力、肱三头肌皮褶厚度、上臂围、上臂肌围、血清清蛋白、血清总蛋白及血红蛋白的测量,分析影响握力的相关因素及握力在营养不良评价中的临界值。[结果]晚期肺癌病人营养不良(整体营养状况主观评估量表评分≥4分)的发生率为64.3%;营养不良组晚期肺癌病人体重、血清清蛋白、血红蛋白均低于营养良好组病人(P<0.05);相关性分析显示,握力与体重、肱三头肌皮褶厚度、上臂围、血清清蛋白、血红蛋白呈正相关(P<0.05),握力与营养状况呈负相关(P<0.05)。握力预测营养不良的ROC曲线下面积>0.7(P<0.05),男性握力<26.2 kg、女性握力<17.8 kg时,可判定病人出现营养不良,预测的敏感度分别为85.2%、76.9%,特异性分别为61.5%、70.0%。[结论]握力测量操作简单,可作为晚期肺癌病人营养状况的快速评估工具,及早筛查营养不良。Objective:To explore the application value of grip strength in the assessment of nutritional status of patients with advanced lung cancer.Methods:A total of 112 patients with advanced lung cancer,who were admitted to the oncology department in a tertiary grade A hospital in Nanning from August 2018 to August 2019,were selected as objects.General information was collected.And the nutritional status was evaluated.Grip strength,triceps skinfold,upper arm circumference,upper arm muscle circumference,serum albumin,total serum protein and hemoglobin were measured.Relevant factors that influencing the grip strength and critical value of grip strength in the evaluation of malnutrition were analyzed.Results:The incidence of malnutrition in patients with advanced lung cancer(score of the subjective assessment scale of overall nutritional status≥4)was 64.3%.The body weight,serum albumin and hemoglobin of the patients with advanced lung cancer in the malnutrition group were all lower than those in the well-nourished group(P<0.05).Correlation analysis showed that grip strength was positively correlated with body weight,triceps skinfold,upper arm circumference,serum albumin and hemoglobin(P<0.05).But grip strength was negatively correlated with nutritional status(P<0.05).The area under the ROC curve of using grip strength to predict malnutrition was above 0.7(P<0.05).When grip strength was less than 26.2 kg in males and less than 17.8 kg in females,it could be defined that the patient with malnutrition.The sensitivity of prediction in males and females were 85.2%and 76.9%,respectively.And the specificity of prediction in males and females were 61.5%and 70.0%,respectively.Conclusions:The measurement of grip strength was easy to operate.And grip strength could be used as a rapid assessment tool for the nutritional status of patients with advanced lung cancer,in order to screen malnutrition as soon as possible.

关 键 词：肺癌 握力 营养不良 营养状态评估 性别 影响因素 

分 类 号：R473.73[医药卫生—护理学]