全程营养管理对消化道肿瘤患者围放疗期营养状况的影响  

The effect of whole course nutrition management on periradiotherapy nutritional status in patients with gastrointestinal cancer

作　　者：王向前[1] 袁小鹏 朱琪伟[1] 杨燕光 丁华[1] 陈树森 羌曹霞 王铃燕 WANG Xiang-qian;YUAN Xiao-peng;ZHU Qi-wei;YANG Yan-guang;DING Hua;CHEN Shu-sen;QIANG Cao-xia;WANG Ling-yan(Department of Radiotherapy,Tumor Hospital Affiliated to Nantong University,Nantong 226361,Jiangsu,China;Department of Nutrition,Tumor Hospital Affiliated to Nantong University,Nantong 226361,Jiangsu,China)

机构地区：[1]南通大学附属肿瘤医院放疗科,南通226361 [2]南通大学附属肿瘤医院营养科,南通226361

出　　处：《中国临床医学》2023年第5期831-835,共5页Chinese Journal of Clinical Medicine

基　　金：南通市卫生健康委员会课题(MB2019021)。

摘　　要：目的探讨给予全程营养管理干预后,对围放疗期间消化道肿瘤患者营养状况以及住院日的影响。方法选取2020年1月至2021年12月南通大学附属肿瘤医院收治的有放射治疗指征的消化道肿瘤患者160例,均采用精确放疗[三维适形放疗(3D-CRT)、调强放疗(IMRT)或容积调强放射治疗(VMAT)],分为常规营养组(n=79)、营养干预组(n=81)。在放疗开始时、放疗结束时及放疗结束后1个月分别测量营养相关血液学指标,包括血红蛋白(Hb)、血白蛋白(Alb)、前白蛋白(PAB)浓度及评分营养评估量表[营养风险筛查(NRS-2002)和患者主观整体营养评估量表(PGSGA)],比较两组指标变化情况。结果营养干预组的Hb、Alb、PAB高于常规营养组(P<0.05),体质量、BMI、NRS-2002、PG-SGA评分优于常规营养组(P<0.05),平均住院日短于常规营养组(P<0.05)。结论全程营养管理可以改善消化道相关肿瘤放、化疗患者基础营养状况,提高患者放疗依从性,缩短患者平均住院日。Objective To explore the effect of whole-course nutritional management intervention on nutritional status and hospital stay in patients with gastrointestinal cancer during periradiotherapy.Methods A total of 160 patients with gastrointestinal tumors indicated for radiotherapy were enrolled in this study.All patients were treated with precise radiotherapy three dimensional comformal radiation therapy(3D-CRT),intensity modulated radiation therapy(IMRT),or volumetric modulated arc therapy(VMAT)and randomly divided into conventional nutrition group(n=79)and nutritional intervention group(n=81).At the beginning of radiotherapy,at the end of radiotherapy,and 1 month after the end of radiotherapy,nutrition-related hematological indicators were measured:The concentration of hemoglobin(Hb),albumin(Alb)and prealbumin(PAB),as well as the nutritional assessment scales(NRS-2002 and PG-SGA),were compared between the two groups.Results Hb,Alb and PAB in the nutrition intervention group were higher than those in the conventional nutrition group(P<0.05).The body weight and BMI of the nutrition intervention group were better than those of the conventional nutrition group(P<0.05).The NRS-2002 and PG-SGA scores of the nutrition intervention group were better than those of the conventional nutrition group(P<0.05).The nutritional intervention group could shorten the average length of hospital stay(P<0.05).Conclusions Whole-course nutrition management can improve the basic nutritional status of patients with gastrointestinal related tumors undergoing radiotherapy and chemotherapy,improve the compliance of patients with radiotherapy,and shorten the average length of hospital stay.

关 键 词：营养评估 消化道肿瘤 放射治疗 营养风险筛查 围放疗期 

分 类 号：R735[医药卫生—肿瘤]