allo-HSCT患者移植期间优化营养干预的效果研究  

Study on effect of optimized nutrition intervention duringtransplantation in allo-HSCT patients

作　　者：杜珊珊 白倩 朱文艺 梁馨予 陶俊 文静 王建 DU Shanshan;BAI Qian;ZHU Wenyi;LIANG Xinyu;TAO Jun;WEN Jing;WANG Jian(Department of Nutrition,Second Affiliated Hospital of Army Military Medical University,Chongqing 400037,China;Department of Hematology,Second Affiliated Hospital of Army Military Medical University,Chongqing 400037,China)

机构地区：[1]陆军军医大学第二附属医院营养科,重庆400037 [2]陆军军医大学第二附属医院血液科,重庆400037

出　　处：《重庆医学》2024年第11期1679-1683,1689,共6页Chongqing medicine

基　　金：陆军军医大学临床新技术准入项目(XJSZR0987)。

摘　　要：目的探讨优化营养干预方案对异基因造血干细胞移植(allo-HSCT)患者移植期间营养状况与临床结局的影响。方法选取2022年1—12月于该院血液科行allo-HSCT的70例患者为研究对象,采用随机数字表法将其分为干预组和对照组,每组35例。对照组行常规营养干预,干预组行优化营养干预。比较两组营养指标及评分[体重、患者全观整体评估(PG-SGA)评分、能量及蛋白质摄入量]、总蛋白(TP)、白蛋白(ALB)、前白蛋白(PA)水平,以及住院时间、住院费用、不良反应发生情况,综合评价两组营养状况与临床结局的差异。结果与对照组比较,干预组进出层流病房时[3.10(1.10,4.80)kg vs.4.30(3.10,6.70)kg]、移植60 d时[3.20(1.00,5.50)kg vs.4.15(3.33,7.88)kg]体重下降幅度更少,出层流病房时PG-SGA评分[(10.43±3.25)分vs.(13.00±3.05)分]更低,出层流病房时PA水平[(189.63±51.29)mg/L vs.(163.83±48.03)mg/L]更高,能量[(753.99±350.66)kcal vs.(539.96±247.65)kcal]和蛋白质[(33.87±15.87)g vs.(20.43±12.57)g]的经口摄入量更多,腹泻发生率(14.3%vs.37.1%)更低,差异有统计学意义(P<0.05)。结论优化allo-HSCT期间的营养干预有利于改善患者的营养状况,降低不良反应发生率。Objective To explore the effects of optimized nutrition intervention scheme on nutritional status and clinical outcome during transplantation in the patients with allogeneic hematopoietic stem cell transplantation(allo-HSCT).Methods Seventy inpatients with allo-HSCT in this hospital from January to December 2022 were selected as the study subjects and divided into the control group and intervention group by the random number table method,35 cases in each group.The control group conducted the conventional nutritional intervention and the intervention group conducted the optimized nutritional intervention.The nutritional indicators[body weight,patient-generated subjective global assessment(PG-SGA),energy and protein intake],levels of total protein(TP),albumin(ALB)and prealbumin(PA),hospitalization duration,hospitalization costs and adverse reactions occurrence were compared between the two groups.The differences in the nutritional status and clinical outcomes in the tow groups were comprehensively evaluated.Results Compared with the control group,the body weight decrease ranges in entering the laminar flow ward and on 60 d of transplantation in the intervention group were much less[3.10(1.10,4.80)kg vs.4.30(3.10,6.70)kg;3.20(1.00,5.50)kg vs.4.15(3.33,7.88)kg],the PG-SGA score was lower[(10.43±3.25)points vs.(13.00±3.05)points],the PA level was higher[(189.63±51.29)mg/L vs.(163.83±48.03)mg/L],the energy and protein oral intakes were much more[(753.99±350.66)kcal vs.(539.96±247.65)kcal;(33.87±15.87)g vs.(20.43±12.57)g],the diarrhea occurrence rate was lower(14.3%vs.37.1%),and the differences were statistically significant(P<0.05).Conclusion Optimizing the nutritional intervention during allo-HSCT period is beneficial to improve the nutritional status of the patients,and reduce the incidence rate of adverse reactions.

关 键 词：异基因造血干细胞移植 营养干预 营养状况 体重 消化道症状 

分 类 号：R459.3[医药卫生—治疗学]