63例男性食管癌患者术前营养状况和不同营养筛查评估方法比较  

Comparison of preoperative nutritional status and different nutritional screening and evaluation methods in 63 male patients with esophageal cancer

作　　者：王子兵 李小玢 刘海珍[1] 李伟[2] 丁宝龙 孙灿 WANG Zibing;LI Xiaobin;LIU Haizhen;LI Wei;DING Baolong;SUN Can(Department of Nutrition,Weifang People’s Hospital,Weifang 261041,China;Department of Thoracic Surgery,Weifang People's Hospital)

机构地区：[1]潍坊市人民医院营养科,山东潍坊261041 [2]潍坊市人民医院胸外科

出　　处：《潍坊医学院学报》2021年第6期459-463,共5页Acta Academiae Medicinae Weifang

基　　金：潍坊市卫健委科研项目资助课题(项目编号:WFWSJK-2020-036)。

摘　　要：目的了解初诊食管癌男性患者营养状况和人体成分,探讨不同营养筛查评估方法对食管癌患者评估结果的一致性。方法选取2020年4月~2021年6月在潍坊市人民医院胸外科初诊食管癌63例男性患者,收集住院相关基本资料信息,并进行体格检查和体成分分析,采用营养风险筛查量表NRS2002、患者主观整体评估量表(PG-SGA)、预后营养指数(PNI)、相位角(PA)和骨骼肌质量指数(SMI)进行营养筛查及评估。用SPSS18.0软件进行统计分析。结果男性食管癌患者中有营养风险35例(55.6%),重度营养不良(PG-SGA C级)20例(31.7%),低预后营养指数(PNI<50)33例(52.4%),低相位角(PA<5°)19例(30.2%),低骨骼肌质量指数(SMI<7kg/m^(2))19例(30.2%)。PG-SGA C级患者体重、BMI、SMI、相位角、上臂围、上臂肌围和握力均低于PG-SGA A+B级,细胞外水/细胞内水值、白细胞计数和C反应蛋白含量均高于PG-SGA A+B级,差异均有统计学意义(P<0.05);两组间体脂百分比、皮褶厚度、血红蛋白、总蛋白和白蛋白指标差异均无统计学意义(P>0.05)。PG-SGA评估与NRS2002、PA、SMI评估结果一致性Kappa系数分别为0.420,0.443,0.443(均有P<0.001)。结论男性食管癌患者营养风险和营养不良发生率较高,PG-SGA与NRS2002、PA和SMI评估患者营养状况具有一致性,联合进行营养评估效果可能会更好。Objective To understand the nutritional status and body composition of male patients with newly diagnosed esophageal cancer, and explore the consistency of evaluation results of different nutritional screening and evaluation methods for esophageal cancer patients.Methods Sixty-three male patients with esophageal cancer newly diagnosed in the Department of Thoracic Surgery of Weifang People’s Hospital from April 2020 to June 2021 were selected as subjects.The basic information related to hospitalization was collected, and the physical examination and body composition analysis were carried out.Nutrition risk screen 2002,patient-generated subjective global assessment(PG-SGA),prognostic nutritional index(PNI),phase angle(PA) and skeletal muscle mass index(SMI) were used for nutritional evaluation and screening.SPSS18.0 software was used for statistical analysis.Results Male patients with esophageal cancer had nutritional risk in 35 cases(55.6%),severe malnutrition(PG-SGA grade C) in 20 cases(31.7%),low prognostic nutritional index(PNI<50) in 33 cases(52.4%),low phase angle(PA<5°) in 19 cases(30.2%),and low skeletal muscle mass index(SMI<7 kg/m^(2)) in 19 cases(30.2%).The body weight, BMI,SMI,phase angle, upper arm circumference, upper arm muscle circumference and grip strength in PG-SGA C group were lower than those in PG-SGA A+B group.The extracellular water/intracellular water value, leukocyte count and C-reactive protein content were higher than those in PG-SGA A+B group, the difference was statistically significant(P<0.05).There was no significant difference in body fat percentage, skinfold thickness, hemoglobin, total protein and albumin between the two groups(P>0.05).The PG-SGA assessment results are consistent with NRS2002 risk screening, PA and SMI assessment results, Kappa coefficients were 0.420,0.443 and 0.443 respectively(P<0.001).Conclusion The incidence of nutritional risk and malnutrition in male patients with esophageal cancer is high.PG-SGA is consistent with NRS2002,PA and SMI in assessing the nu

关 键 词：食管肿瘤 营养状况 营养风险 营养不良 营养评估 

分 类 号：R735.1[医药卫生—肿瘤]