腫瘤化療患者營養現狀及營養支持治療的調查

侯雙雁 黃世慶 龍華 葉婷 林承雄

【摘要】 目的 調查首次化療前百色市某醫院腫瘤患者的營養風險、營養不良情況及化療期間營養支持情況。方法 選取2017年5月～2018年8月百色市某三甲醫院化療病區收治的確診惡性腫瘤并接受首次化療的患者為研究對象。入院后48小時內使用營養風險篩查量表（NRS2002）進行篩查和評估營養不良情況，并記錄入院和第一周期化療結束之間的營養支持情況。結果 本次共調查121例患者，營養風險發生率為50.41%，營養不良發生率為42.15%。在61例有營養風險的患者中營養支持率為18%。腸外和腸內營養的比例為12∶2（6∶1）。營養支持能量攝入量為（14.99±5.90）kcal/（kg·d），氮量為（0.13±0.05）g/（kg·d）。結論 該地區卵巢癌及消化道腫瘤患者營養風險、營養不良發生率較高，但營養支持的應用尚未規范，需加強臨床醫師對“腸內與腸外營養臨床診療指南”的培訓。

【關鍵詞】 營養風險篩查2002;營養風險;營養不良;營養支持;化療

中圖分類號：R730.5 ? 文獻標志碼：A ? DOI：10.3969/j.issn.1003-1383.2019.07.014

【Abstract】 Objective To investigate the nutritional risk and malnutrition before the first chemotherapy as well as nutritional support during chemotherapy.Methods Patients who were diagnosed with malignant tumors and received the first chemotherapy in chemotherapy ward from a tertiary hospital in Baise City from May 2017 to August 2018 were selected as research subjects.Nutritional Risk Screening 2002（NRS2002） was performed and malnutrition was estimated within 48 hours of admission，and nutritional support was recorded between the period of admission and the end of the first cycle of chemotherapy.Results A total of 121 patients were surveyed，the incidence of nutritional risk was 50.41%，and the incidence of malnutrition was 42.15%.The nutritional support rate was 18% in 61 patients with nutritional risk，and the ratio of parenteral nutrition and enteral nutrition was 12∶2（6∶1）.The energy intake of nutritional support was（14.99±5.90） kcal/（kg·d），and that of nitrogen was（0.13±0.05） g/（kg·d）.Conclusion The incidence of nutritional risk and malnutrition in patients with ovarian cancer and gastrointestinal cancer is high in this area，but the application of nutritional support has not been standardized.Therefore，it is necessary to strengthen the training of clinicians on the guidelines for Clinical Practice of Enteral and Parenteral Nutrition.

【Key words】 NRS2002;nutritional risk;malnutrition;nutritional support;chemotherapy

惡性腫瘤是一種代謝性疾病，相對其他住院患者其存在更高的營養不良發生率及營養風險發生率[1]。營養不良可導致腫瘤患者對手術、放療、化療的耐受性降低[2～3]，延緩抗腫瘤治療的進行，甚至無法進行有效的手術、放化療、免疫及靶向治療等抗腫瘤治療，從而縮短腫瘤患者的生存時間及降低抗腫瘤治療的效果?；煴徽J為是治療惡性腫瘤的三種主要方法之一，絕大部分患者在治療過程中離不開化療?；熆赡軙殡S較嚴重的毒副作用，因此體力狀態極差及嚴重營養不良的惡病質狀態均被視為化療禁忌?！?br>