基于简易营养评价精法评估肝癌患者出院后营养状况及其影响因素  

Evaluation of nutritional status and influencing factors of patients with primary liver cancer after discharge based on Mini Nutritional Assessment-Short Form

作　　者：顾娇娇[1] 邹燕 陈奕辰 黄师菊[2] 张慧玲[1] 林楠[1] Jiaojiao Gu;Yan Zou;Yichen Chen;Shiju Huang;Huiling Zhang;Nan Lin(Department of Hepatobiliary Surgery,the Third Affiliated Hospital of Sun Yat-sen University,Guangzhou 510630,China;Department of General Surgery,the Third Affiliated Hospital of Sun Yat-sen University,Guangzhou 510630,China)

机构地区：[1]中山大学附属第三医院肝胆外科,广州510630 [2]中山大学附属第三医院外科,广州510630

出　　处：《中华肝脏外科手术学电子杂志》2023年第5期534-539,共6页Chinese Journal of Hepatic Surgery(Electronic Edition)

基　　金：广东省医学科学技术研究基金(A2019047)。

摘　　要：目的探讨原发性肝癌(肝癌)患者出院后营养恢复状况及其影响因素。方法本研究对象为2019年7月1日至2021年1月31日在中山大学附属第三医院治疗并出院的70例肝癌患者。患者均签署知情同意书,符合医学伦理学规定。其中男60例,女10例;年龄28~78岁,中位年龄55岁。采用一般资料调查表、简易营养评价精法(MNA-SF)在出院当天(T1)、出院3个月(T2)、6个月(T3)对70例肝癌患者进行问卷调查。采用重复测量方差分析对3个时间点的营养状况进行比较,采用单因素方差分析和多元线性逐步回归分析营养状况影响因素。结果肝癌患者T1、T2、T3时间点平均营养状况评分分别为(9.3±1.8)、(10.2±2.0)、(11.2±2.2)分,3个时间点差异有统计学意义(F=23.891,P<0.05)。其中3个时间点营养不良发生率分别为17%(12/70)、6%(4/70)、4%(3/70),营养风险发生率分别73%(51/70)、67%(47/70)、49%(34/70)。回归分析显示,BMI、血清前白蛋白、腹腔积液、治疗方式是患者T1时间点营养状况的独立影响因素(t=3.968,2.721,-2.224,2.653;P<0.05);BMI、TB、治疗方式是患者T2时间点营养状况的独立影响因素(t=4.890,2.814,-5.346;P<0.05);BMI、治疗方式是患者T3时间点营养状况的独立影响因素(t=4.698,-5.052;P<0.05)。结论肝癌患者出院后营养状况逐步好转,但营养风险及营养不良发生率仍较高。对于BMI下降、血清前白蛋白降低、TB升高、腹腔积液和肝癌切除术后患者应在住院和居家期间进行营养干预,改善其营养状况,降低营养风险和营养不良发生率。Objective To evaluate the nutritional recovery status and influencing factors of patients with primary liver cancer(PLC)after discharge.Methods 70 PLC patients who were treated and discharged from the Third Affiliated Hospital of Sun Yat-sen University from July 1,2019 to January 31,2021 were recruited in this study.The informed consents of all patients were obtained and the local ethical committee approval was received.Among them,60 patients were male and 10 female,aged 28-78 years with a median age of 55 years.70 PLC patients were investigated by Baseline Data Questionnaire and Mini Nutritional Assessment-Short Form(MNA-SF)on the day of discharge(T1),3(T2)and 6 months(T3)after discharge,respectively.The nutritional status at three time points was compared by repeated measures analysis of variance.The influencing factors of nutritional status were identified by univariate analysis of variance and multiple stepwise linear regression analysis.Results The average nutritional status scores of PLC patients at T1,T2 and T3 were 9.3±1.8,10.2±2.0 and 11.2±2.2,and significant differences were observed(F=23.891,P<0.05).At three time points,the incidence of malnutrition was 17%(12/70),6%(4/70)and 4%(3/70),and the incidence of nutritional risk was 73%(51/70),67%(47/70)and 49%(34/70),respectively.Regression analysis showed that body mass index(BMI),prealbumin,ascites and treatment pattern were the independent influencing factors of nutritional status at T1(t=3.968,2.721,-2.224,2.653;P<0.05).BMI,total bilirubin(TB)and treatment pattern were the independent influencing factors of nutritional status at T2(t=4.890,2.814,-5.346;P<0.05).BMI and treatment pattern were the independent influencing factors of nutritional status at T3(t=4.698,-5.052;P<0.05).Conclusions The nutritional status of PLC patients is gradually improved after discharge,whereas the incidence of nutritional risk and malnutrition remains high.For patients with decreased BMI,decreased serum prealbumin,increased TB,ascites and those undergoing liver cancer resec

关 键 词：肝肿瘤 营养状况 影响因素 简易营养评价精法 

分 类 号：R735.7[医药卫生—肿瘤]