328例消化道恶性肿瘤患者营养状况评价

目的前瞻性评价消化道恶性肿瘤患者的营养状况,探析营养不良的相关因素。方法应用主观综合性营养评价法(SGA)、血清前白蛋白和白蛋白水平评价328例初诊消化道恶性肿瘤患者的营养状况,分析影响其营养状况的因素。结果①营养不良的发生率为64.43%,其中各部位肿瘤营养不良的发生率分别为:结肠癌75.81%、食管癌63.24%、胃癌62.40%、直肠癌60.27%;②营养状况改变的主要表现为:67.39%患者有不同程度体质量丢失,24.1%的患者血清前白蛋白水平<200g/L、31.7%的患者白蛋白水平<35g/L,且不同营养状况患者的体质量丢失量、血清前白蛋白和白蛋白水平间有显著性差异(P=0.000);③影响营养状况的因素:肿瘤部位和TNM分期、宿主年龄、食欲和消化道症状等。结论消化道恶性肿瘤部位和肿瘤对宿主造成的代谢改变等因素易致患者营养不良,临床应重视对住院恶性肿瘤患者营养状况的筛选、评价和早期营养干预。

Nutrition assessment in 328 patients with alimentary tract malignancy

Objective To prospectively assess the nutritional status in the patients with alimentary tract malignancy,and to elucidate the factors related to malnutrition.Methods The nutritional status of 328 patients with newly diagnosed alimentary tract malignancy was assessed using subjective global assessment(SGA)and serum levels of prealbumin and albumin.And the factors influencing the nutritional status of the patients with alimentary tract malignancy in different locations were analyzed.Results The prevalence of malnutrition was 64.43% in all,75.81% in colon cancer,63.24% in esophageal cancer,62.40% in gastric cancer and 60.27% in rectal cancer.The changes of nutritional status mainly manifested weight loss with the incidence of 67.39%,serum prealbumin level under 200 g/L with the incidence of 24.1% and serum albumin level less than 35 g/L with the incidence of 31.70%.And there was significant difference in weight loss and serum levels of prealbumin and albumin among the patients with different nutritional status(P=0.000).The factors that influence the nutritional status of the patients with alimentary tract malignancy include the location and TNM staging of tumors,and the age,appetite and digestive symptoms of the patients.Conclusion The patients with alimentary tract malignancy are susceptible to malnutrition due to the multiple factors such as the tumor location and metabolic impacts of tumor on host.Nutritional screening,assessment and early intervention should be emphasized in the inpatients with alimentary tract malignancy.