营养助理模式在头颈部肿瘤放化疗患者营养干预中的应用研究  

Application study of a nutritional assistant role in nutritional intervention of head and neck cancer sufferers undergoing chemoradiotherapy

作　　者：王淑安[1] 冯庆钊 王漪[3] 徐燕[4] 陈晓甜[1] 张楠[5] Wang Shu'an;Feng Qinghao;Wang Yi;Xu Yan;Chen Xiootian;Zhang Nan(Department of Clinie Nurition,Nanjing Drum Tover Hopital,Afflited Hospital of Nanjing Uniersity Medical Schoo,Nanjing 210008,Jiangsu,China;Departmnent of General Surgery,Nanjing Drum Tower Hospital,Affiliated Hopital of Nanjing University Medical School,Nanjing 210008,Jiangsu,China;Department of Oncology,Nanjing Drum Touer Hospital,Affiliated Hospital of Nanjing Unitesity Medical School,Nanjing 210008,Jiangsu,China;Jiangsu Prouincial Center for Disease Control and Prevention,Nanjing 210009,Jiangsu,China;Depatment of Clinical Laboratory,Nanjing Drum Tower Hospita,Affiliated Hospital of Nanjing Uniersity Medical School,Nanyjing 210008,Jiangsu,China)

机构地区：[1]南京大学医学院附属鼓楼医院临床营养科,江苏南京210008 [2]南京大学医学院附属鼓楼医院普外科,江苏南京210008 [3]南京大学医学院附属鼓楼医院肿瘤科,江苏南京210008 [4]江苏省疾病预防控制中心,江苏南京210009 [5]南京大学医学院附属鼓楼医院检验科,江苏南京210008

出　　处：《肿瘤代谢与营养电子杂志》2023年第3期348-353,共6页Electronic Journal of Metabolism and Nutrition of Cancer

基　　金：南京鼓楼医院学科振兴项目(2022-LCYJ-ZX-09);南京鼓楼医院医学教育研究项目(HB1248202101)。

摘　　要：目的探究营养助理模式对头颈部肿瘤患者根治性放化疗期间营养方案执行程度、营养状况和身心状态的影响。方法收集2018年6月至2021年12月南京鼓楼医院肿瘤中心收治的头颈部肿瘤患者,采用随机数字表法将观察对象随机分为两组,对照组(常规护理模式,n=72)和干预组(营养助理模式,n=66)。所有患者均采用根治性同步放化疗方案。比较两组能量和蛋白质的实际摄入量、心理、生活质量和营养指标变化。结果治疗过程中,两组能量摄入量减少幅度差异无统计学意义(P>0.05),同时干预组蛋白质的摄入量高于对照组,差异有统计学意义(P<0.05);心理及生活质量方面,医院焦虑抑郁评估量表(HADS)评分和生活质量量表Karnofsky功能状态(KPS)评分,干预组的评分均优于对照组,差异有统计学意义(P<0.05);营养指标方面,干预组在体重和血清白蛋白指标上均优于对照组,差异有统计学意义(P<0.05),而C反应蛋白指标两组无统计学差异(P>0.05)。结论在头颈部肿瘤根治性放化疗中,营养助理模式可能有利于帮助患者维持能量摄入水平,从而使患者维持较好的营养状况和身心健康状态。Objective To explore the effects of a nutritional ssitant nursing-mode in bead and neck cancer patients undegoing radiotherapy whose degree of implementation of nutrition programmes and impact on nutition status and physical and mental health.Method 138 patients with head and neck cancer in Nanjing Drum Tower Hoepital from June 2018 to December 2021 were selected and randomly divided into control group(n=72)and observation group(n=66).The intervention group,patients adopted the mursing-mode of a nutritional assistant role.In the control group was treated with routine nursing-mode.All patients received radical ooncurrent chemoradiotherapy.Then,the nutrient intaking,nutritional indexes,the degree of anxiety and depression a well a quality of life were compared between the two groups.Result The energies of the two groups were decreased,while the indexes of intervention group were better at other time points but there was no statistical signifcance(P>0.05).The proteins intakes of the intervention group were better between two groups(P<0.05).The HADS and KPS scores of the intervention group were better(P<0.05).The indexes of serum albumin and weight in the intervention group were better except CRP(P<0.05).Conclusion In the treatment of head and neck cancer,the mursing-mode of a nutritional assistant role may help to maintain patients"energy a well as protein intaking.In addition,it may also alleviate nutritional status and the plhysical and peychological healthy states.

关 键 词：营养助理 营养不良 头颈肿瘤 身心状态 

分 类 号：R739.91[医药卫生—肿瘤]