头颈部肿瘤放疗患者的多学科营养管理实践

Application of multidisciplinary nutrition management to head and neck cancer patients receiving radiotherapy

目的探讨头颈部肿瘤患者放疗期间多学科营养管理模式的应用效果。方法将88例头颈部肿瘤放疗患者按住院时间分为观察组46例和对照组42例。观察组在放疗开始前1周进行多学科营养管理直至放疗结束,对照组进行常规营养指导。每2周随访1次。比较两组患者在放疗起始、放疗2周、放疗4周及放疗结束时24h能量和蛋白摄入量、1个月体质量下降比例及PG-SGA定量评分的变化。结果两组放疗期间24h能量和蛋白摄入1个月体质量下降比例和PG-SGA定量评分比较,组间效应、时间效应、交互效应均P<0.01。结论实施多学科营养管理能有效增加头颈部肿瘤患者放疗期间24h能量及蛋白摄入量,减少体质量丢失,更好地改善营养状态。

Objective To investigate the effect of multidisciplinary nutrition management on head and neck cancer patients receiving radiotherapy.Methods Totally,88 head and neck cancer patients receiving radiotherapy were recruited,and assigned to receive either routine nutritional guidance(the control group,n=42)or multidisciplinary nutrition management,starting from 1 week before radiotherapy to the end of the therapy(the intervention group,n=46).The patients were followed up every 2 weeks during radiotherapy.The changes of indexes(amounts of 24-hour energy and protein intake,1-month weight loss percentages and PG-SGA scores)were measured and compared between the two groups at four different stages of radiotherapy,including the initiation,the 2nd week,the 4th week,and the end of radiotherapy.Results There were significant group effect,time effect and group by time effect in all the above-mentioned indexes between the 2 groups(P<0.01 for all).Conclusion Application of multidisciplinary nutrition management to head and neck cancer patients receiving radiotherapy could result in an increased 24-hour energy and protein intake,a decrease in weight loss and better nutrition status for patients.