论文部分内容阅读
目的调查重庆市人民医院常见恶性肿瘤住院患者的营养状况。方法采用营养风险筛2002、PG-SGA、体格测量、实验室检测等方法对重庆市人民医院自2015年5月4日至2015年12月31日的311例16种常见恶性肿瘤住院患者进行营养风险筛查、营养评估,并调查这些患者的营养治疗情况。结果 311例患者中,有营养风险(NRS 2002≥3分)的为44.37%(138/311)。以PG-SGA评分评估患者营养状况,结果显示,52.73%(164/311)的肿瘤患者存在中度营养不良(PG-SGA≥4分),其中31.19%(97/311)为重度营养不良(PG-SGA≥9分);消化道肿瘤患者营养不良的发生率比非消化道肿瘤患者高(65.41%vs.43.26%,χ~2=13.417,P<0.001);多元线性回归分析体质指数、血清白蛋白、血清前白蛋白、最近1个月体重下降百分比、左小腿围、非利手握力与PG-SGA评分之间有相关性(P均<0.001),其中左小腿围、最近1个月体重下降百分比与PG-SGA评分相关性最好(回归系数B分别为-0.872、0.861,P<0.001),血红蛋白、上臂肌围与PG-SGA评分相关性不具统计学意义(P分别为0.268,0.218);中、重度营养不良患者的营养治疗率仅为43.90%(72/164),营养治疗以单独肠外营养治疗为主,占91.7%(66/72),肠内营养联合肠外营养占6.94%(5/72),单独肠内营养治疗仅1例,占营养治疗患者的1.38%(1/72)。结论 52.73%的常见恶性肿瘤患者存在中、重度营养不良。PG-SGA评分是评估肿瘤患者营养不良简便、有效的工具,营养不良的患者营养治疗率低,且以肠外营养为主,肠内营养治疗率极低。建议对恶性肿瘤患者进行入院后的营养风险筛查以及包括PG-SGA评分在内的全面营养评估,并给予正确的营养治疗。
Objective To investigate the nutritional status of inpatients with common malignant tumors in Chongqing People’s Hospital. Methods Nutritional risk screen 2002, PG-SGA, physical measurement, laboratory tests and other methods were used to evaluate the nutritional status of 311 patients with 16 common malignant tumors in Chongqing People’s Hospital from May 4, 2015 to December 31, 2015 Risk screening, nutrition assessment, and investigating nutritional status in these patients. Results Of the 311 patients, the nutritional risk (NRS 2002 ≥ 3) was 44.37% (138/311). The nutritional status of patients was assessed by PG-SGA score. The results showed that there were moderate malnutrition (PG-SGA≥4) in 52.73% (164/311) of the cancer patients, of which 31.19% (97/311) were severe malnutrition PG-SGA≥9). The incidence of malnutrition in patients with gastrointestinal cancer was higher than that in patients with non-gastrointestinal cancer (65.41% vs.43.26%, χ ~ 2 = 13.417, P <0.001); Multiple linear regression analysis of body mass index, Serum albumin, prealbumin, body weight loss in the last month, left leg circumference, non-profit grip strength and PG-SGA score were significantly correlated (P <0.001) The correlation between monthly body weight loss and PG-SGA score was the best (regression coefficient B = -0.872,0.861, P <0.001, P <0.001). The correlation between hemoglobin and arm muscle circumference and PG-SGA score was not statistically significant , 0.218). The nutritional treatment rate of moderate and severe malnutrition patients was only 43.90% (72/164). Nutritional therapy was mainly parenteral nutrition treatment, accounting for 91.7% (66/72), enteral nutrition combined with parenteral nutrition Nutrition accounted for 6.94% (5/72), only one case of enteral nutrition alone, accounting for 1.38% (1/72) of patients treated nutrition. Conclusions 52.73% of the common malignant tumor patients have moderate and severe malnutrition. The PG-SGA score is a simple and effective tool for assessing malnutrition in patients with cancer. Malnourished patients have low rates of nutritional therapy and are mainly parenteral nutrition with very low rates of enteral nutrition. Nutritional risk screening of patients with malignancies after admission and a comprehensive nutritional assessment including PG-SGA scores are recommended and proper nutrition therapy is recommended.