重度营养不良恶性肿瘤患者营养干预依从性对营养状况的影响  

Effect of nutritional intervention compliance on nutritional status in malignant tumor patients with severe malnutrition

作　　者：王辉[1] 苏先旭[1] 胡梦迪 周星野 吴甜甜 宋春花[2] Wang Hui;Su Xianxu;Hu Mengdi;Zhou Xingye;Wu Tiantian;Song Chunhua(Department of Oncology,the People’s Hospital of Dujiangyan,Dujiangyan 611830,Sichuan China;Department of Epidemiology and Statistics,College of Public Health,Zhengzhou University,Zhengzhou 450001,Henan China)

机构地区：[1]都江堰市人民医院肿瘤科,四川都江堰611830 [2]郑州大学公共卫生学院流行病学与统计学系,郑州450001

出　　处：《肿瘤代谢与营养电子杂志》2022年第5期631-638,共8页Electronic Journal of Metabolism and Nutrition of Cancer

基　　金：吴阶平医学基金会科研课题(320.6750.19001)。

摘　　要：目的 探讨恶性肿瘤患者伴重度营养不良营养干预依从性对营养状况的影响。方法 回顾性分析2019年4月至2021年6月都江堰市人民医院肿瘤科收治的506例恶性肿瘤伴重度营养不良患者,采用营养风险筛查2002(NRS 2002)、患者主观整体评估(PG-SGA)、简明膳食自评工具对患者进行筛查评估,采用营养治疗五阶梯原则进行营养诊断、营养治疗、疗效评价及随访,根据患者对制订营养治疗计划的依从性进行分组(营养治疗开始2周后,根据服药依从性量表评估患者依从性,评分<6分入依从性差组,评分≥6分入依从性好组),并监测两组患者血常规、白蛋白、前白蛋白、体能、身高、体重等营养指标。结果 对60岁以下肿瘤患者营养干预2周后,在血钾、白蛋白、握力、2周体重丢失率方面的变化,依从性好的患者优于依从性差的患者(均P <0.05);对60岁及以上肿瘤患者营养干预2周后,在红细胞、白蛋白、前白蛋白、C反应蛋白、握力、2周体重丢失率方面的变化,依从性好的患者优于依从性差的患者(均P <0.05)。依从性好的肿瘤患者体力状况评分[2(2,3)分]低于依从性差的患者[3(2,3)分],膳食评分[3(1,3)分]高于依从性差的患者[2(1,3)分]。体力状况评分<3分或≥3分、膳食评分<3分或≥3分的肿瘤患者营养干预2周后,在白蛋白、前白蛋白、握力、2周体重丢失率方面的变化,均为依从性好的患者优于依从性差的患者(均P <0.05)。结论 恶性肿瘤伴重度营养不良患者经过规范的营养治疗,依从性好的患者在快速变化指标如白蛋白和前白蛋白,中速变化指标如握力和2周后体重丢失率方面,均得到明显的改善。Objective To investigate the effect of nutritional intervention compliance on nutritional status and clinical outcome of patients with malignant tumor with severe malnutrition.Method A retrospective analysis was performed on 506 patients with malignant tumor and severe malnutrition admitted to the Department of Oncology from April 2019 to June 2021.The patients were screened and evaluated by nutritional risk screening(NRS 2002),tumor nutrition assessment(PG-SGA),and simple dietary self-assessment tools.Using nutritional treatment principle of five steps to nutrition diagnosis,treatment and curative effect evaluation and follow-up,nutrition therapy plan according to the patient’s compliance to group(2 weeks after treatment with nutrition to assess patients compliance,score < 6 points into poor compliance group,scoring six points into the good compliance group or higher),Blood routine,albumin,prealbumin,physical fitness,height,weight and other nutritional indicators were monitored in 2 groups.Result After nutritional intervention for tumor patients under 60 years old for two weeks,the changes of blood potassium,albumin,grip strength and weight loss rate in two weeks were better in patients with good compliance than those with poor compliance(all P < 0.05).The changes of RBC,albumin,prealbumin,CRP,grip strength and twoweek weight loss rate in tumor patients aged 60 years and over after nutritional intervention for two weeks were better in patients with good compliance than in patients with poor compliance(all P < 0.05).The physical status score of tumor patients with good compliance [2(2,3) ]was lower than that of tumor patients with poor compliance [3(2,3) ],and the dietary score [3(1,3) ] was higher than that of tumor patients with poor compliance [2(1,3) ].Patients with PS score < 3 points or ≥ 3 points and dietary score < 3 points or ≥ 3 points had better compliance than those with poor compliance in terms of albumin,prealbumin,grip strength and weight loss rate within two weeks after nutritional intervent

关 键 词：恶性肿瘤 重度营养不良 营养干预 依从性 

分 类 号：R730[医药卫生—肿瘤]