胃癌根治术后患者化疗症候群和营养状况分析  

Analysis of symptoms and nutritional status of patients undergoing chemotherapy radical gastrectomy for gastric cancer

作　　者：王长霞[1] 居玲玲[1] 钱湘云[1] 李玮玮[1] 秦相清[1] WANG Changxia;JU Lingling;QIAN Xiangyun;LI Weiwei;QIN Xiangqing(Nantong Third People's Hospital,Nantong Jiangsu 226000,China)

机构地区：[1]南通市第三人民医院,江苏南通226000

出　　处：《新疆医科大学学报》2020年第12期1589-1594,共6页Journal of Xinjiang Medical University

基　　金：江苏省第五期“333工程”科研资助立项项目(BRA2017206)。

摘　　要：目的分析胃癌根治术后患者化疗期间的症候群,并对患者的营养状况进行动态观察。方法收集276例胃癌根治术后进行化疗的患者为研究对象,由专职调查员利用化疗患者症状测评问卷及患者主观整体评估问卷(PG-SGA)对患者相关情况进行调查评估,收集数据,进行统计分析。结果(1)胃癌患者化疗期间,共观察到33种不良反应。根据不良症状的特征,分为5个症候群,分别为消化道症候群、心理症候群、躯体症候群、化疗相关症候群、胃癌特异性症候群。(2)在所有化疗相关症状中,“食欲降低”、“感到悲伤”、“乏力”的发生率最高,“食欲降低”、“恶心”、“焦虑不安”的严重程度最高。(3)Spearman相关性分析发现,各症候群严重程度得分与患者生理状况、社会家庭状况、情感状况、功能状况评分均呈明显的负相关关系(-1<r<0,P<0.05)。(4)PG-SGAA级、B级、C级分别有53例(19.20%)、195例(70.65%)、28例(10.14%),分别代表营养良好、可疑或中度营养不良、重度营养不良。与化疗前期比较,患者在化疗后期的营养得分明显升高,而前白蛋白、血红蛋白、体重指数(BMI)水平仍然较低(P<0.05)。(5)将PG-SGA与传统营养学指标相比,结果发现,患者年龄越大,PG-SGA等级越高,患者营养状况越差;随着PG-SGA评估等级的升高,BMI、肱三头肌皮皱厚度(TSF)、上臂围(AC)、上臂肌围(AMC)、血清总蛋白(TP)、白蛋白(AIB)、血红蛋白(Hb)、红细胞计数(RBC)、生活质量评分(KPS)逐渐降低,其营养状况越差(P<0.05)。结论临床中应关注“食欲降低”、“感到悲伤”、“乏力”等高发生率的不良症状,对患者的营养状态进行动态评估、个体化干预,将有助于提高患者的生活质量。Objective To analyze the symptoms of patients with gastric cancer during chemotherapy after radical gastrectomy, and dynamically observe the nutritional status of patients. Methods 276 cases of gastric cancer patients undergoing chemotherapy after radical gastrectomy were collected as the research objects. The professional investigators used the symptom assessment questionnaire and patient-generatedsubjectiveglobalassessment(PG-SGA) to investigate and evaluate the relevant situation of patients, collect data and conduct statistical analysis. Results(1)33 kinds of adverse reactions were observed in patients with gastric cancer during chemotherapy. According to the characteristics of the adverse symptoms, it can be divided into five syndromes: gastrointestinal syndrome, psychological syndrome, somatic syndrome, chemotherapy related syndrome and gastric cancer specific syndrome.(2)Among all the chemotherapy-related symptoms, the incidence of "loss of appetite", "feeling sad", "fatigue" was the highest, and the severity of "loss of appetite", "nausea" and "anxiety and anxiety" were the highest.(3)Spearman correlation analysis showed that there was a significant negative correlation between the severity scores of each syndrome and the scores of physiological status, social and family status, emotional status and functional status(-1 <r< 0, P< 0.05).(4)There were 53 cases(19.20%), 195 cases(70.65%), and 28 cases(10.14%) of PG-SGA grade A, B, and C, respectively, representing good nutrition, suspicious or moderate malnutrition, and severe malnutrition. Compared with the pre-chemotherapy period, the patient’s nutritional score was significantly increased in the post-chemotherapy period, while the levels of prealbumin, hemoglobin, and body mass index(BMI) were still low(P<0.05).(5) Comparing PG-SGA with traditional nutritional indicators, it is found that the older the patient, the higher the PG-SGA grade and the worse the patient’s nutritional status;as the PG-SGA assessment grade increases, BMI and triceps Skin wrin

关 键 词：胃癌 生存质量 症候群 营养 

分 类 号：R735.2[医药卫生—肿瘤]