胃肠肿瘤化疗患者营养风险筛查和营养支持状况分析

目的探讨胃肠肿瘤化疗患者营养风险发生率和营养支持状况,为合理使用营养支持提供参考。方法采用营养风险筛查2002(NRS2002)对136例胃肠肿瘤患者化疗前营养风险进行评估,其中NRS3分64例(NRS阴性组),NRS≥3分72例(NRS阳性组)。根据是否进行肠外营养支持,将NRS阳性组中的患者分为观察组和对照组,每组各36例。比较患者化疗前后营养指标及不良反应。结果 136例患者中,营养风险的发生率为52.9%。≥50岁组患者NRS≥3分的比率为62.0%,显著高于50岁组的43.1%(P0.05);化疗4周期后,各组白蛋白(ALB)、前白蛋白(PA)、血红蛋白(HB)水平较化疗前有所下降,NRS阳性对照组ALB、PA及HB水平均显著低于观察组(P0.05);观察组肝脏损伤的程度显著低于对照组(P0.05)。结论胃肠肿瘤化疗患者营养风险发生率高,化疗期间给予营养支持能改善其营养状态,提高其对化疗的耐受性,改善预后。

Screening on nutritional risk and analysis of nutritional support in patients with gastrointestinal tumor during chemotherapy.

Objective To explore the incidence of nutritional risk and status of nutritional support in patients with gastrointestinal tumor during chemotherapy, and to provide the evidence for rational application of nutritional support. Methods A total of 136 patients with gastrointes- tinal tumor during chemotherapy including 64 cases of NRS 〈 3 （ NRS negative group） and 72 cases of NRS 〉~ 3 （ NRS positive group） were as- sessed by Nutritional Risk Screening in 2002 （ NRS2002）. According to whether administration of parenteral nutrition support or not, patients in NRS positive group were divided into observation group （n = 36） and control group （n = 36 ）. The nutritional status and main toxicities were ob- served. Results In these 136 eases, the incidence of nutritional risk was 52.9%. The percentage of NRS ~〉3 in patients aged over 50 years old was 62.0% , which was higher than that （43.1% ） of patients aged under 50 years old （ P 〈 0.05 ）. After chemotherapy for 4 weeks, the blood levels of ALB, PA and HB in all groups were reduced compared with those before chemotherapy, these indicators in control group were all lower than those of observation group P 〈 0.05 ）. The degree of liver impairment in observation group was significantly lower than that of control group （ P 〈 0. 05）. Conclusion The incidence of nutritional risk in patients with gastrointestinal tumor during chemotherapy is high, nutritional support during chemotherapy can improve nutrition status and enhance the tolerance of chemotherapy, hence their prognosis may be improved.