腫瘤患者營養(yǎng)狀況調(diào)查及其影響因素分析
發(fā)布時(shí)間：2018-11-22 09:08
【摘要】：背景近年來,惡性腫瘤患者的發(fā)病率處于上升趨勢,惡性腫瘤患者營養(yǎng)不良高發(fā)。多數(shù)腫瘤患者死于營養(yǎng)不良而非腫瘤疾病本身,惡性腫瘤營養(yǎng)不良成為影響人類健康的重要疾病。全球每年有超過200萬腫瘤患者死于嚴(yán)重的營養(yǎng)不良,因此本研究采用國內(nèi)外較為常用的腫瘤患者營養(yǎng)不良評估方法-患者主觀整體評估法(patient-generated subjective global assessment,PG-SGA),對腫瘤患者進(jìn)行營養(yǎng)狀況評估并分析影響腫瘤患者營養(yǎng)不良的因素,探索PG-SGA法的實(shí)用性和可行性,并為腫瘤患者的營養(yǎng)干預(yù)及支持提供依據(jù)。目的采用患者主觀整體評估法(PG-SGA)對安徽省腫瘤醫(yī)院放化療科腫瘤患者進(jìn)行營養(yǎng)評估,并分析影響腫瘤患者營養(yǎng)不良的多種因素。方法應(yīng)用PG-SGA法對2014年2月1日至2016年8月31日在安徽省腫瘤醫(yī)院放化療科住院治療的996例腫瘤患者,入院48h內(nèi)完成營養(yǎng)評估。并將其分為營養(yǎng)狀況良好(PG-SGA A級)、可疑或中度營養(yǎng)不良(PG-SGA B級)、重度營養(yǎng)不良(PG-SGA C級)三組;PG-SGA A級歸為無營養(yǎng)不良組、PG-SGA B級與PG-SGA C級歸為營養(yǎng)不良組,并收集患者基本信息及各項(xiàng)客觀營養(yǎng)指標(biāo)。分析各因素與營養(yǎng)不良的關(guān)系。結(jié)果1.本研究共納入959例惡性腫瘤患者,PG-SGA A級366例(38.16%)、PG-SGA B級268例(27.95%)、PG-SGA C級325例(33.89%),營養(yǎng)不良發(fā)生率為61.84%。其中胃癌為83.22%,食管癌為78.53%,結(jié)直腸癌55.29%,宮頸癌為51.66%,肺癌營養(yǎng)不良發(fā)生率為51.11%,乳腺癌為40.30%。2.多因素Logistic回歸分析結(jié)果顯示:性別(OR=0.164)、年齡(OR=0.958)、體重指數(shù)(OR=11.769)、低蛋白血癥(OR=10.982)、放療(OR=1.629)、口干(OR=0.038)、早飽(OR=0.053)、非利手(或非損傷手)握力(OR=1.060)是惡性腫瘤發(fā)生營養(yǎng)不良的獨(dú)立危險(xiǎn)因素。結(jié)論1.PG-SGA法是一種可靠、適合臨床廣泛應(yīng)用的惡性腫瘤患者營養(yǎng)狀況評價(jià)工具;建議常規(guī)對入院的腫瘤患者進(jìn)行PG-SGA評估,為臨床治療提供依據(jù)。2.營養(yǎng)不良在惡性腫瘤患者,特別是消化道腫瘤患者的發(fā)生率比較高,定期的對腫瘤患者進(jìn)行營養(yǎng)評估,及時(shí)予以營養(yǎng)干預(yù)及支持,是十分必要的。3.惡性腫瘤患者發(fā)生營養(yǎng)不良的影響因素復(fù)雜多樣,應(yīng)關(guān)注營養(yǎng)不良的危險(xiǎn)因素,早日實(shí)現(xiàn)腫瘤患者個(gè)體化、規(guī)范化的營養(yǎng)干預(yù)與支持治療;由于營養(yǎng)不良的發(fā)生機(jī)制尚未完全明確,未來我們需要繼續(xù)深入探索。
[Abstract]:Background in recent years, the incidence of malignant tumor patients is on the rise, high incidence of malnutrition in patients with malignant tumors. Most cancer patients die of malnutrition rather than tumor disease itself, and malignant tumor malnutrition has become an important disease affecting human health. More than 2 million cancer patients die from severe malnutrition every year in the world. Therefore, this study adopts the domestic and foreign more commonly used methods for the evaluation of malnutrition in cancer patients-patient subjective global assessment (patient-generated subjective global assessment,PG-SGA). The nutritional status of tumor patients was evaluated and the factors affecting malnutrition were analyzed to explore the practicability and feasibility of PG-SGA method and to provide evidence for nutritional intervention and support of tumor patients. Objective to evaluate the nutritional status of tumor patients in the department of radiotherapy and chemotherapy in Anhui Cancer Hospital by using subjective holistic assessment (PG-SGA), and to analyze the factors affecting malnutrition in tumor patients. Methods from February 1, 2014 to August 31, 2016, a total of 996 patients with cancer were enrolled in the department of radiotherapy and chemotherapy in Anhui Cancer Hospital. The nutritional evaluation was completed within 48 hours of admission. They were divided into three groups: good nutritional status (PG-SGA A), suspected or moderate malnutrition (PG-SGA B) and severe malnutrition (PG-SGA C). PG-SGA A was classified as no malnutrition, PG-SGA B and PG-SGA C were classified as malnutrition, and basic information and objective nutritional indexes were collected. The relationship between various factors and malnutrition was analyzed. Result 1. A total of 959 patients with malignant tumors were included in this study. There were 366 cases (38.16%) with PG-SGA A grade, 268 cases (27.95%) with PG-SGA B grade and 325 cases (33.89%) with PG-SGA C grade. The incidence of malnutrition was 61.84%. Among them, 83.22 stomach cancer, 78.53 esophageal carcinoma, 55.29 colorectal cancer, 51.66 cervical cancer, 51.11 lung cancer malnutrition and 40.30 percent breast cancer. The results of multivariate Logistic regression analysis showed: sex (OR=0.164), age (OR=0.958), body mass index (OR=11.769), hypoproteinemia (OR=10.982), radiotherapy (OR=1.629), dry mouth (OR=0.038), early satiety (OR=0.053). Hand-free (or non-invasive) grip strength (OR=1.060) is an independent risk factor for malnutrition in malignant tumors. Conclusion 1.PG-SGA method is a reliable and suitable tool for evaluating the nutritional status of patients with malignant tumor, and it is suggested that routine evaluation of PG-SGA should be carried out to provide the basis for clinical treatment. 2. The incidence of malnutrition in patients with malignant tumor, especially in patients with digestive tract tumor is relatively high. It is very necessary to evaluate the nutrition of cancer patients regularly and give nutrition intervention and support in time. The influencing factors of malnutrition in patients with malignant tumor are complex and diverse, so we should pay attention to the risk factors of malnutrition, realize individualization of tumor patients as soon as possible, and standardize nutritional intervention and support therapy. As the mechanism of malnutrition is not yet fully understood, we need to explore further in the future.
【學(xué)位授予單位】：新鄉(xiāng)醫(yī)學(xué)院
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R730.5
本文編號：2348805
[Abstract]:Background in recent years, the incidence of malignant tumor patients is on the rise, high incidence of malnutrition in patients with malignant tumors. Most cancer patients die of malnutrition rather than tumor disease itself, and malignant tumor malnutrition has become an important disease affecting human health. More than 2 million cancer patients die from severe malnutrition every year in the world. Therefore, this study adopts the domestic and foreign more commonly used methods for the evaluation of malnutrition in cancer patients-patient subjective global assessment (patient-generated subjective global assessment,PG-SGA). The nutritional status of tumor patients was evaluated and the factors affecting malnutrition were analyzed to explore the practicability and feasibility of PG-SGA method and to provide evidence for nutritional intervention and support of tumor patients. Objective to evaluate the nutritional status of tumor patients in the department of radiotherapy and chemotherapy in Anhui Cancer Hospital by using subjective holistic assessment (PG-SGA), and to analyze the factors affecting malnutrition in tumor patients. Methods from February 1, 2014 to August 31, 2016, a total of 996 patients with cancer were enrolled in the department of radiotherapy and chemotherapy in Anhui Cancer Hospital. The nutritional evaluation was completed within 48 hours of admission. They were divided into three groups: good nutritional status (PG-SGA A), suspected or moderate malnutrition (PG-SGA B) and severe malnutrition (PG-SGA C). PG-SGA A was classified as no malnutrition, PG-SGA B and PG-SGA C were classified as malnutrition, and basic information and objective nutritional indexes were collected. The relationship between various factors and malnutrition was analyzed. Result 1. A total of 959 patients with malignant tumors were included in this study. There were 366 cases (38.16%) with PG-SGA A grade, 268 cases (27.95%) with PG-SGA B grade and 325 cases (33.89%) with PG-SGA C grade. The incidence of malnutrition was 61.84%. Among them, 83.22 stomach cancer, 78.53 esophageal carcinoma, 55.29 colorectal cancer, 51.66 cervical cancer, 51.11 lung cancer malnutrition and 40.30 percent breast cancer. The results of multivariate Logistic regression analysis showed: sex (OR=0.164), age (OR=0.958), body mass index (OR=11.769), hypoproteinemia (OR=10.982), radiotherapy (OR=1.629), dry mouth (OR=0.038), early satiety (OR=0.053). Hand-free (or non-invasive) grip strength (OR=1.060) is an independent risk factor for malnutrition in malignant tumors. Conclusion 1.PG-SGA method is a reliable and suitable tool for evaluating the nutritional status of patients with malignant tumor, and it is suggested that routine evaluation of PG-SGA should be carried out to provide the basis for clinical treatment. 2. The incidence of malnutrition in patients with malignant tumor, especially in patients with digestive tract tumor is relatively high. It is very necessary to evaluate the nutrition of cancer patients regularly and give nutrition intervention and support in time. The influencing factors of malnutrition in patients with malignant tumor are complex and diverse, so we should pay attention to the risk factors of malnutrition, realize individualization of tumor patients as soon as possible, and standardize nutritional intervention and support therapy. As the mechanism of malnutrition is not yet fully understood, we need to explore further in the future.
【學(xué)位授予單位】：新鄉(xiāng)醫(yī)學(xué)院
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R730.5
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