头颈部肿瘤患者放化疗期间营养状态调查及其与放射性咽炎、疼痛的相关性分析  

Investigation on Nutritional Status of Patients with Head and Neck Tumors during Radiotherapy and Chemotherapy and its Correlation with Radiation Pharyngitis and Pain

作　　者：庞志明[1] 邹颖珊 PANG Zhi-ming;ZOU Ying-shan(Foshan First People’s Hospital,Foshan,Guangdong,528000,China)

机构地区：[1]佛山市第一人民医院,广东佛山528000

出　　处：《黑龙江医学》2022年第10期1222-1225,共4页Heilongjiang Medical Journal

摘　　要：目的:分析调查头颈部肿瘤患者放化疗期间营养状态及其与放射性咽炎、疼痛的相关性。方法:选取2019年6月-2020年3月佛山市第一人民医院收治的98例头颈部肿瘤患者作为研究对象,对纳入研究的患者进行统一规范的放化疗治疗。对患者在放疗前、放疗第四周、放疗最后一周的营养风险发生情况、体重(BW)、身体质量指数(BMI)、血红蛋白(Hb)、白蛋白(Alb)等血液学检查指标、放射性咽炎分级、疼痛评分等进行统计比较。并采用Pearson检验对患者的营养状况与放射性咽炎分级、疼痛评分的相关性进行分析探讨。结果:经营养风险筛查量表(NRS2002)评估,放疗最后一周营养风险发生率高于放疗第四周且高于放疗前,差异有统计学意义(χ^(2)=10.212;χ^(2)=26.826,P<0.05)。放疗最后一周BW、BMI、Hb、Alb水平均低于放疗第四周且低于放疗前,差异有统计学意义(t=2.618、3.727、2.089、2.126;t=5.160、7.085、4.200、5.393,P<0.05)。放疗最后一周放射性咽炎分级、疼痛数字评分量表(NRS)评分均高于放疗第四周且高于放疗前,差异有统计学意义(t=5.520、4.649;t=20.019、20.535,P<0.05)。同步放化疗患者相比于单纯放疗患者,BW、Hb水平进一步降低,放射性咽炎分级、NRS评分进一步提高,差异有统计学意义(t=2.237、3.006、2.580,P<0.05)。经Pearson检验分析,放化疗患者营养指标包括BW、BMI、Hb、Alb与放射性咽炎分级、NRS评分呈负相关性,差异有统计学意义(r=-0.489、-0.510、-0.493、-0.499;-0.482、-0.501、-0.517、-0.515,P<0.05)。结论:头颈部肿瘤患者在放化疗过程中存在较高的营养发生风险,营养相关指标表现为持续恶化,并且与患者的放射性咽炎、疼痛程度呈负相关性。因此,早期营养筛查,治疗中准确有效监测和评估营养指标,对于降低放射性毒副反应发生具有重要临床意义。Objective: To investigate the nutritional status of patients with head and neck cancer during radiotherapy and chemotherapy and its correlation with radiation pharyngitis and pain. Methods: A total of 98 patients with head and neck tumors who were admitted to the hospital from June 2019 to March 2020 were selected as the research subjects. The patients included in the study were treated with a unified standard of radiotherapy and chemotherapy. The incidence of nutritional risk, body weight(BW), body mass index(BMI), hemoglobin(Hb), albumin(Alb) and other hematological indexes, radioactive pharyngitis grading, pain score were observed before radiotherapy, the fourth week of radiotherapy and the last week of radiotherapy. Pearson test was used to analyze the correlation between nutritional status and radiation pharyngitis grade and pain score. Results: As assessed by the Nutritional Risk Screening Scale(NRS2002), the incidence of nutritional risk in the last week of radiotherapy was higher than that in the fourth week of radiotherapy and higher than that before radiotherapy, with statistically significant differences between groups(χ^(2)=10.212, χ^(2)=26.826, P<0.05).The levels of BW, BMI, Hb, and Alb in the last week of radiotherapy were lower than those in the fourth week of radiotherapy and lower than those before radiotherapy, and the differences between groups were statistically significant(t=2.618, 3.727,2.089, 2.126, t=5.160, 7.085, 4.200, 5.393, P<0.05). Radiation pharyngitis grade and pain Numerical Rating Scale(NRS) scores in the last week of radiotherapy were higher than those in the fourth week of radiotherapy and higher than those before radiotherapy, with significant differences between groups(t=5.520, 4.649, t=20.019, 20.535, P<0.05). Compared with patients with radiotherapy alone,the BW and Hb levels in patients with concurrent radiotherapy and chemotherapy were further decreased, and the radiopharyngitis grade and NRS score were further increased, and the differences between groups were statistic

关 键 词：头颈部肿瘤 放化疗治疗 营养状况 放射性咽炎 疼痛程度 相关性分析 

分 类 号：R739.91[医药卫生—肿瘤]