强化营养管理在鼻咽癌同步放化疗患者中的应用
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摘要
目的:探讨强化营养管理在鼻咽癌同步放化疗患者中的应用效果。方法:选择2017年12月1日～2019年1月31日行同步放化疗的140例鼻咽癌患者为研究对象。将2017年12月1日～2018年6月30日的68例患者分为对照组,给予常规营养教育和护理,出院门诊常规电话随访;将2018年7月1日～2019年1月31日的72例患者分为观察组,在营养管理小组的协同作用下,住院化疗及出院门诊放疗期间实施追踪式强化营养管理。比较两组每周放疗后膳食摄入量、体重、患者主观全面营养评定量表(PG-SGA)评分及放疗6周后毒副反应发生率。结果:两组膳食摄入量、PG-SGA评分时间效应、组间效应及交互作用差异均有统计学意义(P<0.01,P<0.05);观察组体重丢失、营养不良程度及口腔黏膜炎、疲乏、味觉改变严重程度均低于对照组(P<0.01,P<0.05)。结论:强化营养管理能增加患者膳食摄入量,改善营养状况,降低毒副反应发生率。
Objective:To explore the effects of intensive nutrition management in nasopharyngeal carcinoma patients undergoing concurrent chemoradiotherapy.Methods:A total of 140 patients with nasopharyngeal carcinoma receiving concurrent chemoradiotherapy in our hospital from December 1,2017 to January 31,2019 were selected as the study subjects.From December 1,2017 to June 30,2018,68 patients in the control group were given routine nutrition education and nursing in hospital and routine telephone follow-up in out-patient clinic.From July 1,2018 to January 31,2019,72 cases of observation group were treated with follow-up intensive nutrition management during in-patient chemotherapy and out-patient radiotherapy under the collaboration of nutrition management team.The dietary intake,body weight,PG-SGA scores after each week of radiotherapy,and the incidence of radiation toxicity after 6 weeks of radiotherapy were compared between the two groups.Results There were significant differences in dietary intake,the time effect,inter-group effect and interaction of dietary intake and PG-SGA between the two groups(P<0.05).The weight loss,malnutrition severity,and the severity of oral mucositis,fatigue and taste changes of the observation group were lower than those of the control group.Conclusion Intensive nutritional management can increase patients′dietary intake,improve nutritional status and reduce the incidence of toxic side effects.
Objective:To explore the effects of intensive nutrition management in nasopharyngeal carcinoma patients undergoing concurrent chemoradiotherapy.Methods:A total of 140 patients with nasopharyngeal carcinoma receiving concurrent chemoradiotherapy in our hospital from December 1,2017 to January 31,2019 were selected as the study subjects.From December 1,2017 to June 30,2018,68 patients in the control group were given routine nutrition education and nursing in hospital and routine telephone follow-up in out-patient clinic.From July 1,2018 to January 31,2019,72 cases of observation group were treated with follow-up intensive nutrition management during in-patient chemotherapy and out-patient radiotherapy under the collaboration of nutrition management team.The dietary intake,body weight,PG-SGA scores after each week of radiotherapy,and the incidence of radiation toxicity after 6 weeks of radiotherapy were compared between the two groups.Results There were significant differences in dietary intake,the time effect,inter-group effect and interaction of dietary intake and PG-SGA between the two groups(P<0.05).The weight loss,malnutrition severity,and the severity of oral mucositis,fatigue and taste changes of the observation group were lower than those of the control group.Conclusion Intensive nutritional management can increase patients′dietary intake,improve nutritional status and reduce the incidence of toxic side effects.
引文
[1] 沈怡.鼻咽癌病人同步放化疗期间营养状况调查及其影响因素分析[D].天津:天津医科大学,2017.
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[3] 石英英,张晓伟,袁凯涛,等.PG-SGA操作标准介绍[J].中华肿瘤防治杂志,2013,20(22):1779-1782.
[4] 翟泽民,张燕忠.肿瘤患者营养筛查及评估方法的研究现状[J].中国基层医药,2017,24(1):137.
[5] 中国抗癌协会肿瘤营养与支持治疗专业委员会.中国肿瘤营养治疗指南[M].北京:人民卫生出版社,2015:46-48.
[6] Langius JA,Zandbergen MC,Eerenstein SE,et al.Effect of nutritional interventions on nutritional status,quality of life and mortality in patients with head and neck cancer receiving(chemo)radiotherapy:a systematic review[J].Clin Nutr,2013,32(5):671-678.
[7] 杨坚娥,冯雪梅.强化式健康教育在持续非卧床腹膜透析患者中的应用[J].齐鲁护理杂志,2015,21(23):36-38.
[8] 王剑锋,方芳,于雷.营养干预对老年头颈部肿瘤放疗病人营养状态及情绪的影响[J].实用老年医学,2017,31(9):847-850.
[9] 叶志英.强化营养护理对血液透析患者生活质量的影响[J].齐鲁护理杂志,2015,21(13):45-46.
[2] 中国抗癌协会,中国抗癌协会肿瘤营养与支持治疗专业委员会.口服营养补充指南[J].肿瘤代谢与营养电子杂志,2015,2(4):33-34.
[3] 石英英,张晓伟,袁凯涛,等.PG-SGA操作标准介绍[J].中华肿瘤防治杂志,2013,20(22):1779-1782.
[4] 翟泽民,张燕忠.肿瘤患者营养筛查及评估方法的研究现状[J].中国基层医药,2017,24(1):137.
[5] 中国抗癌协会肿瘤营养与支持治疗专业委员会.中国肿瘤营养治疗指南[M].北京:人民卫生出版社,2015:46-48.
[6] Langius JA,Zandbergen MC,Eerenstein SE,et al.Effect of nutritional interventions on nutritional status,quality of life and mortality in patients with head and neck cancer receiving(chemo)radiotherapy:a systematic review[J].Clin Nutr,2013,32(5):671-678.
[7] 杨坚娥,冯雪梅.强化式健康教育在持续非卧床腹膜透析患者中的应用[J].齐鲁护理杂志,2015,21(23):36-38.
[8] 王剑锋,方芳,于雷.营养干预对老年头颈部肿瘤放疗病人营养状态及情绪的影响[J].实用老年医学,2017,31(9):847-850.
[9] 叶志英.强化营养护理对血液透析患者生活质量的影响[J].齐鲁护理杂志,2015,21(13):45-46.