基于营养风险筛查2002评分的综合性营养管理在食管癌和胃癌患者放化疗期间的应用研究  

Research on the application of comprehensive nutrition management based on nutritional risk screening 2002 score in esophageal and gastric cancer patients during radiochemotherapy

作　　者：陈莉莉[1] 陈蕾[2] 王云[2] 葛方红[2] 徐燕飞[3] 许容芳[4] Chen Lili;Chen Lei;Wang Yun;Ge Fanghong;Xu Yanfei;Xu Rongfang(Ambulatory Ward,Nantong Cancer Hospital Southern Hospital,Nantong 226361,Jiangsu,China;Department of Chest Radiotherapy,Nantong Cancer Hospital,Nantong 226361,Jiangsu,China;Department of Internal Medicine,Nantong Cancer Hospital,Nantong 226361,Jiangsu,China;Department of Nursing,Nantong Cancer Hospital,Nantong 226361,Jiangsu,China)

机构地区：[1]南通市肿瘤医院南院日间病房,江苏南通226361 [2]南通市肿瘤医院胸部放疗科,江苏南通226361 [3]南通市肿瘤医院内科,江苏南通226361 [4]南通市肿瘤医院护理部,江苏南通226361

出　　处：《消化肿瘤杂志（电子版）》2023年第4期358-362,共5页Journal of Digestive Oncology(Electronic Version)

基　　金：南通市科技计划项目(MSZ2022138)。

摘　　要：目的探讨基于营养风险筛查2002(nutritional risk screening 2002,NRS2002)评分的综合性营养管理在食管癌和胃癌患者放化疗期间的应用。方法选取南通市肿瘤医院于2020年1月至2023年1月收治的食管癌及胃癌放化疗患者86例,依据随机数字表法分为观察组43例与对照组43例。对照组患者实施常规护理干预,观察组在常规护理干预基础上结合基于NRS2002评分的综合性营养管理。两组干预时间由放化疗开始至放化疗结束。比较两组患者干预前后的心理状况、自我管理能力、营养指标和生存质量变化,以及患者的营养状况。结果两组患者干预后焦虑自评量表(self-rating anxiety scale,SAS)和抑郁自评量表(self-rating depression scale,SDS)评分低于干预前(P<0.05);观察组患者干预后SAS评分和SDS评分低于对照组(P<0.05)。两组患者干预后自我管理能力测定量表(the rating scale of health self-management skillfor adults,AHSMSRS)评分高于干预前(P<0.05);观察组患者干预后AHSMSRS评分高于对照组(P<0.05)。对照组患者干预后血红蛋白(hemoglobin,Hb)、白蛋白(albumin,ALB)和前白蛋白(prealbumin,PA)水平低于干预前(P<0.05);观察组患者干预后Hb、ALB和PA水平较干预前无明显变化(P>0.05);观察组患者干预后Hb、ALB和PA水平高于对照组(P<0.05)。观察组患者营养状况良好率高于对照组(P<0.05)。两组患者干预后躯体健康能力、癌症造成的负担、社会关系健康和心理健康评分高于干预前(P<0.05);观察组患者干预后躯体健康能力、癌症造成的负担、社会关系健康和心理健康评分高于对照组(P<0.05)。结论基于NRS2002评分的综合性营养管理在食管癌及胃癌患者放化疗期间的应用效果良好,可显著改善患者心理状况和营养状况,提高患者自我管理能力,以及提高患者生存质量。Objective To explore the application of comprehensive nutritional management based on nutritional risk screening 2002(NRS2002)score in esophageal and gastric cancer patients during radiotherapy and chemotherapy.Method 86 esophageal and gastric cancer patients treated with radiotherapy and chemotherapy in our hospital from January 2020 to January 2023 were selected,and divided into an observation group of 43 cases and a control group of 43 cases,according to the random number table method.The control group received routine nursing intervention,while the observation group received comprehensive nutrition management based on NRS2002 score on top of routine nursing intervention.The intervention time of two groups was from the beginning of radiotherapy and chemotherapy to the end.The psychological status,self-management ability,nutritional indicators,quality of life changes,and nutritional status of two groups were compared before and after intervention.Result After intervention,the self-rating anxiety scale(SAS)and self-rating depression scale(SDS)scores of two groups were lower than before(P<0.05),while the SAS and SDS scores of observation group were lower than those of control group(P<0.05).Affer intervention,the rating scale of health self-management skill for adults(AHSMSRS)score of two groups was higher than before(P<0.05),while the AHSMSRS score of observation group was higher than that of control group(P<0.05).After intervention,the levels of hemoglobin(Hb),albumin(ALB)and prealbumin(PA)of two groups were lower than before(P<0.05),while the levels of Hb,ALB and PA of observation group showed no significant changes compared with those before intervention(P>0.05);and the levels of Hb,ALB and PA of observation group were higher than those of control group(P<0.05).The rate of good nutritional status of observation group was higherthan that of control group(P<0.05).After intervention,the physical health ability,burden caused by cancer,social relationship health,and mental health scores of two groups were higher th

关 键 词：营养风险筛查 综合性营养管理 食管癌 胃癌 放化疗 

分 类 号：R473.73[医药卫生—护理学]