消化道恶性肿瘤化疗病人营养状况现况调查和影响因素分析

目的:通过调查消化道恶性肿瘤单纯行化疗病人的营养状态及支持的现况,并分析相关影响因素,为后期制定针对性的营养支持护理方案提供理论依据。方法:选取2019年1月~2019年9月上海长海医院757例消化道恶性肿瘤单纯行化疗的病人为调查对象,运用营养风险筛查2002(NRS 2002)评分表和病人主观整体营养状况评估量表(PG-SGA)进行营养不良分级,对相关影响因素进行分析。结果:757例消化道肿瘤病人中存在营养风险的占35.4%,其中可疑营养不良占19.4%,中度营养不良占54.8%,重度营养不良占25.7%。最近2周体质量变化、有无"无食欲"、"呕吐"、"腹泻"、"疼痛"等症状以及年龄≥65岁是消化道肿瘤化疗病人营养不良的主要影响因素。营养支持现状:87.3%的病人接受营养教育,66.4%接受营养支持,营养支持并发症发生率高。结论:单纯化疗的消化道肿瘤病人营养不良发生率高,化疗后胃肠道不良反应的发生以及营养支持并发症的发生是影响营养状况的主要原因,做好症状管理以及规范营养支持是改善该类病人营养状况的主要方向。

Investigation on nutritional status of patients with gastrointestinal cancer undergoing chemotherapy

Objective: To investigate the nutritional status of patients undergoing exclusive chemotherapy for gastrointestinal malignancies and analyze related influencing factors, so as to provide a theoretical basis for formulating targeted nutrition support nursing programs. Methods: From January 2019 to September 2019, 757 patients with gastrointestinal malignancies in a tertiary hospital were selected as the subjects of investigation. The nutrition risk screening 2002(NRS 2002) and the patient-generated subjective global assessment(PG-SGA) score tables were used for nutritional assessment. Related influencing factors were analyzed. Results: Among the 757 patients with gastrointestinal cancer, 35.4% had nutritional risks, of which 19.4% were suspected to be malnourished, 54.8% were moderately malnourished, and 25.7% were severely malnourished. Changes in body weight in the last 2 weeks, the presence of "no appetite", "vomiting", "diarrhea", "pain" and other symptoms, and age ≥65 years are the main influencing factors of malnutrition in this group of patients. 87.3% of patients received nutritional education and 66.4% received nutritional support. The incidence of complication of nutritional support was high. Conclusion: The incidence of malnutrition in patients with gastrointestinal cancers subjected to exclusive chemotherapy is high. The occurrence of gastrointestinal adverse reactions after chemotherapy and the occurrence of nutritional support complications are the main reasons affecting the nutritional status. Optimizing symptom management and nutritional support are the main strategy to improve the nutrition status of this group of patients.