胃癌根治术患者术后化疗期间营养状况及相关因素分析
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摘要
目的研究胃癌根治术后患者化疗期间营养状况,分析影响患者营养状况的相关因素,为制订合理的干预措施提供科学依据。方法回顾性分析行胃癌根治术且接受完整化疗的150例胃癌患者的临床资料,采用整体营养状况主观评估量表(PG-SGA)评估患者术后化疗期间的营养状况,胃癌根治术患者术后营养不良相关影响因素采用Logistic逐步回归分析。结果胃癌根治术患者术后PG-SGA量表平均得分为(6.21±2.17)分,其中营养不良85例,占56.7%;营养良好65例,占43.3%。Logistic回归分析结果显示,初中、小学及以下文化程度,居住地为农村,家庭月收入≤5000元,化疗期间未进行肠外营养支持和有早饱感是胃癌根治术患者术后发生营养不良的独立危险因素。结论应重点关注文化程度低、收入低等胃癌根治术患者的营养状况,加强其化疗期间肠外营养支持,制订个体化饮食指导方案,改善患者的营养状况。
Objective To explore the nutritional status in postoperative patients with gastric cancer undergoing chemotherapy, and to analyze the factors affecting the nutritional status of patients, to so as to provide scientific basis for formulating reasonable intervention. Method Clinical data of 150 patients who underwent radical resection of gastric cancer and underwent complete chemotherapy were analyzed retrospectively. The nutritional status of patients during chemotherapy were measured by the scored patient-generated subjective global assessment(PG-SGA). The logistic stepwise regression was used to analyze the influencing factors of malnutrition in patients with gastric cancer after radical operation.Result The average PG-SGA score of patients with radical gastrectomy was(6.21±2.17), of which 85 patients were malnourished, accounting for 56.7%, 65 patients were with good nutrition, accounting for 43.3%. The result logistic stepwise regression showed that the education level of junior school, primary school or below, with rural residence, monthly family income ≤5000 yuan, no parenteral nutrition support during chemotherapy and feeling of early satiety were all independent risk factor for malnutrition in patients with radical gastrectomy. Conclusion The nutritional status of patients underwent radical gastrectomy with low level of education and income should be emphasized, the parenteral nutrition during the chemotherapy should be strengthened and individualized dietary guidance programs should be formulated to improve the nutritional status of patients.
Objective To explore the nutritional status in postoperative patients with gastric cancer undergoing chemotherapy, and to analyze the factors affecting the nutritional status of patients, to so as to provide scientific basis for formulating reasonable intervention. Method Clinical data of 150 patients who underwent radical resection of gastric cancer and underwent complete chemotherapy were analyzed retrospectively. The nutritional status of patients during chemotherapy were measured by the scored patient-generated subjective global assessment(PG-SGA). The logistic stepwise regression was used to analyze the influencing factors of malnutrition in patients with gastric cancer after radical operation.Result The average PG-SGA score of patients with radical gastrectomy was(6.21±2.17), of which 85 patients were malnourished, accounting for 56.7%, 65 patients were with good nutrition, accounting for 43.3%. The result logistic stepwise regression showed that the education level of junior school, primary school or below, with rural residence, monthly family income ≤5000 yuan, no parenteral nutrition support during chemotherapy and feeling of early satiety were all independent risk factor for malnutrition in patients with radical gastrectomy. Conclusion The nutritional status of patients underwent radical gastrectomy with low level of education and income should be emphasized, the parenteral nutrition during the chemotherapy should be strengthened and individualized dietary guidance programs should be formulated to improve the nutritional status of patients.
引文
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[8]何卫芳.胃癌根治术后患者化疗期营养状况及影响因素研究[D].郑州:郑州大学, 2016.
[9]李绮雯,李桂超,王亚农,等.胃癌辅助放化疗患者的营养状态与放化疗不良反应及治疗耐受性的关系[J].中华胃肠外科杂志, 2013, 16(6):529-533.
[10] Strong VE, Wu AW, Selby LV, et al. Differences in gastric cancer survival between the U.S. and China[J]. J Surg Oncol, 2015, 112(1):31-37.
[11] Qiu M, Zhou YX, Jin Y, et al. Nutrition support can bring survival benefit to high nutrition risk gastric cancer patients who received chemotherapy[J]. Support Care Cancer, 2015, 23(7):1933-1939.
[12]刘虹.胃癌患者的营养膳食[J].中国卫生标准管理,2015, 6(32):261-262.
[13]杨宏辉,王喜华,冯春古.中医饮食调护对胃癌术后化疗患者营养状况的影响[J].中国中医药现代远程教育,2015, 13(23):132-133.
[2]季加孚.我国胃癌防治研究三十年回顾[J].中国肿瘤临床, 2013, 40(22):1345-1351.
[3] CSCO肿瘤营养治疗专家委员会.恶性肿瘤患者的营养治疗专家共识[J].临床肿瘤学杂志, 2012, 17(1):59-73.
[4] Ottery FD. Rethinking nutritional support of the cancer patient:the new field of nutritional oncology[J]. Semin Oncol, 1994, 21(6):770-778.
[5] Marano L, Porfidia R, Pezzella M, et al. Clinical and immunological impact of early postoperative enteral immunonutrition after total gastrectomy in gastric cancer patients:a prospective randomized study[J]. Ann Surg Oncol, 2013, 20(12):3912-3918.
[6]石汉平,李薇. PG-SGA肿瘤病人营养状况评估操作手册[M].北京:人民卫生出版社, 2013.
[7]孙晓红,胡芳.患者自评-主观全面评定量表在胃肠恶性肿瘤患者营养筛查中的应用调查[J].中国全科医学, 2014,17(14):1643-1645.
[8]何卫芳.胃癌根治术后患者化疗期营养状况及影响因素研究[D].郑州:郑州大学, 2016.
[9]李绮雯,李桂超,王亚农,等.胃癌辅助放化疗患者的营养状态与放化疗不良反应及治疗耐受性的关系[J].中华胃肠外科杂志, 2013, 16(6):529-533.
[10] Strong VE, Wu AW, Selby LV, et al. Differences in gastric cancer survival between the U.S. and China[J]. J Surg Oncol, 2015, 112(1):31-37.
[11] Qiu M, Zhou YX, Jin Y, et al. Nutrition support can bring survival benefit to high nutrition risk gastric cancer patients who received chemotherapy[J]. Support Care Cancer, 2015, 23(7):1933-1939.
[12]刘虹.胃癌患者的营养膳食[J].中国卫生标准管理,2015, 6(32):261-262.
[13]杨宏辉,王喜华,冯春古.中医饮食调护对胃癌术后化疗患者营养状况的影响[J].中国中医药现代远程教育,2015, 13(23):132-133.