恶性实体瘤儿童营养状况及影响因素研究  

Nutritional status and influencing factors of children with malignant solid tumor

作　　者：颜莓 唐维兵[1] 黄婕[2] 方拥军[2] 刘长伟[1] 万园园 夏晓娜 朱亭 潘键 YAN Mei;TANG Weibing;HUANG Jie;FANG Yongjun;LIU Changwei;WAN Yuanyuan;XIA Xiaona;ZHU Ting;PAN Jian(Department of Clinical Nutrition,Children’s Hospital of Nanjing Medical University,Nanjing 210008,Jiangsu,China;Department of Hematology and Oncology,Children’s Hospital of Nanjing Medical University,Nanjing 210008,Jiangsu,China)

机构地区：[1]南京医科大学附属儿童医院临床营养科,江苏南京210008 [2]南京医科大学附属儿童医院血液肿瘤科,江苏南京210008

出　　处：《临床儿科杂志》2021年第5期327-331,共5页Journal of Clinical Pediatrics

基　　金：中国健康促进基金会“儿科营养支持团队(NST)发展科研公益项目(2019年度)”的支持

摘　　要：目的观察恶性实体瘤儿童初诊与治疗3个月后营养状况变化,并分析其影响因素。方法回顾分析2018年3月至2019年9月住院治疗的104例实体瘤患儿的临床资料。患儿均于入院24小时内采用STRONGkids进行营养风险筛查,并行膳食摄入分析;根据WHO 2006儿童生长标准评定患儿营养状况。比较分析患儿入院时及治疗3个月后营养状况及影响因素。结果实体瘤患儿中男61例、女43例,中位年龄4.5岁。实体瘤患儿初诊时营养不良发生率27.9%;治疗3个月后体质指数Z评分明显下降,差异有统计学意义(P<0.05),治疗3个月后营养不良发生率为48.0%。Logistic回归显示,入院时患儿营养状况、STRONGkids营养风险评分是患儿治疗后营养不良的影响因素(P<0.05)。结论实体瘤患儿治疗过程中容易发生营养状况恶化,对于营养不良及营养风险评分高的患儿,应尽早给予合理的营养支持干预。Objective This study aimed to investigate the nutritional status of children newly diagnosed with malignant solid tumor and the changes during therapy,and to identify factors associated with malnutrition during therapy.Method We enrolled 104 children with malignant solid tumor received inpatient treatment at the Department of Hematology and Oncology in Nanjing Medical University Affiliated Children’s Hospital between March 2018 and September 2019.STRONGkids was used for nutritional risk screening.Dietary intake was analyzed within 24 h,and nutritional status were assessed according to WHO 2006 child growth standards.The influencing factors of malnutrition after 3 months of treatment were analyzed.Results At diagnosis,there were 61 males and 43 females,with a median age of 4.5 years old,27.9%of the patients were malnourished,BMI-Z decreased significantly after treatment,and the difference was statistically significant(P<0.05).During anticancer therapy,the incidence of malnutrition rose to 48%after 3 months.Logistic regression showed that the nutritional status at diagnosis and STRONGkids nutritional risk score were positively associated with a higher proportion of malnutrition(P<0.05).Conclusion Children with solid tumor are prone to nutritional deterioration during treatment.For children with malnutrition and high nutritional risk score,reasonable nutritional support intervention should be given as soon as possible.

关 键 词：实体瘤 营养不良 儿童 

分 类 号：R730.5[医药卫生—肿瘤]