肿瘤化疗患者营养风险评估及影响因素分析

摘要

[Objective] To evaluate the nutritional status and the incidence of nutritional risk of tumor patients treated with chemotherapy in hospital,analyze the factors that cause the nutritional risk of patients,provide reference for patients with malnutrition and nutrition risk,so as to they can have clinical nutrition support therapy in timely.[Method] Nutritional risk screening (NRS2002) was used to screen 236 patients who had been hospitalized for chemotherapy.The nutritional status of the patients were assessed by body mass index,serum hemoglobin,albumin and total protein levels The correlation analysis was carried out with NRS2002 score.[Result] Of the 236 patients who treated with chemotherapy,114 cases were male,accounting for 48.3％.The number of female patients was 122,accounting for 51.7％.Among them,142 patients had nutritional risk,accounting for 60.2％.The incidence of nutritional risk was 66.7％,69.0％,61.9％,66.7％,33.3％ and 56.0％respectively in respiratory system,digestive system,head and neck cancer,lymphoid hematopoietic system,gynecological system and urinary system There was a higher risk of nutritional risk in patients with digestive tumor disease.Nutritional risk was positively correlated with age (r =0.042,P＜0.05),and negatively correlated with HGB (r =-0.015,P ＜0.05),and negatively correlated with ALB (r =-0.103,P ＜0.05),and negatively correlated with BMI (r =-0.086,P ＜ 0.05).Sort by the size of normalization coefficient,the effect of the dependent variable nutrition risk was ALB,BMI,age,HGB.[Conclusion] Tmnor patients treated with chemotherapy have high incidence of nutritional risk,which associated with tumor patient's disease,age,anemia,albumin and BMI,we should strengthen the nutritional assessment,support nutritional treatment in time,so as to improve their clinical outcome.%目的:探讨肿瘤化疗患者的营养状况及营养风险的发生率,分析引起患者营养风险的危险因素,为存在营养不良及营养风险的患者及时进行临床营养支持治疗提供科学依据.方法:采用营养风险筛查2002(NRS2002)对236例肿瘤内科住院进行化疗治疗的患者进行营养风险筛查,并通过测评体质指数、检测血清血红蛋白、白蛋白、总蛋白水平等评定患者营养状况,并将其与NRS2002得分进行相关性分析.结果:236例进行化疗治疗的肿瘤患者中,男性患者114例,占48.3％;女性患者122例,占51.7％;其中有142例患者存在营养风险,占60.2％;呼吸系统、消化系统、头颈部肿瘤、淋巴造血系统、妇科系统、泌尿系统等系统疾病化疗患者营养风险发生率分别是66.7％、69.0％、61.9％、66.7％、33.3％、56.0％.基础疾病情况对是否发生营养风险是有统计学意义的影响因素(P＜0.05),其中消化系统肿瘤患者有营养风险的比率较高.营养风险与年龄呈正相关(r =0.042,P＜0.05),与HGB呈负相关(r=-0.015,P＜0.05),与ALB呈负相关(r=-0.103,P＜0.05),与BMI呈负相关(r=-0.086,P＜0.05),标准化系数的绝对值最大的是ALB,其次是BMI,然后是年龄,最后是HGB,所以对因变量营养风险的作用按大小排列依次是ALB、BMI、年龄、HGB.结论:进行化疗治疗的肿瘤患者,化疗期间营养风险的发生率较高,且营养风险的发生与患者的基础疾病、年龄、是否贫血、白蛋白水平及BMI等均有相关性,对于该类患者进行营养评估时应加强动态监控,发现营养风险时,临床上对其及时进行营养支持治疗,改善患者的临床结局.