生态系统理论指导下的营养管理对急性淋巴细胞白血病化疗患儿营养状态的影响

Effects of nutrition management under the guidance of ecosystem theory on nutritional status of children undergoing chemotherapy for acute lymphoblastic leukemia

目的:分析生态系统理论指导下的营养管理对急性淋巴细胞白血病(ALL)化疗患儿营养状态的影响。方法:选取2021年1月至2021年12月郑州大学第一附属医院收治的86例ALL患儿,采用群随机的方法分为对照组和观察组,每组各43例。对照组采取常规的营养管理,观察组采用生态系统理论指导下的营养管理。干预前后采用全自动生化仪检测血清白蛋白(ALB)、前白蛋白(PA)和转铁蛋白(TFN)水平,测量患儿上臂围、三角肌皮褶厚度,采用Piper疲乏量表评估癌因性疲乏程度。记录患儿干预期间不良反应发生情况。结果:干预后观察组血清ALB、PA、TFN、上臂围较干预前的下降幅度小于对照组(P<0.05),躯体疲乏、认知疲乏、情感疲乏、综合疲乏评分下降幅度大于对照组(P<0.05)。观察组粒细胞减少、血小板减少、肝损伤、恶心呕吐、腹泻和黏膜炎症的总不良反应发生率均低于对照组(P<0.05)。结论:生态系统理论指导的营养管理可有效维持ALL化疗患儿的营养状态,提高患儿化疗耐受性。

Aim:To analyze the effects of nutrition management under the guidance of ecosystem theory on nutritional status of children undergoing chemotherapy for acute lymphoblastic leukemia(ALL).Methods:A total of 86 children with ALL admitted to the hospital between January and December 2021 were enrolled,and were allocated into control group and observation group using group randomization method,with 43 in each group.Control group was given routine nutritional management,while observation group was given nutrition management under the guidance of ecosystem theory.Before and after intervention,the serum levels of albumin(ALB),prealbumin(PA)and transferrin(TFN)were determined using full-automatic biochemical analyzer,upper arm circumference and skinfold thickness of deltoid were measured,cancer-related fatigue(CRF)degree was evaluated by Piper fatigue scale.The drug side effects during chemotherapy were recorded.Results:The degree of drop in serum levels of ALB,PA,TFN and upper arm circumference after intervention of observation group was less than that of control group(P<0.05),and the degree of drop in physical fatigue score,cognitive fatigue score,emotional fatigue score,and comprehensive fatigue score in observation group was more than that of control group(P<0.05).The total incidence of granulopenia,thrombocytopenia,liver injury,nausea and vomiting,diarrhea and mucosal inflammation in observation group was lower than that of control group(P<0.05).Conclusion:Nutrition management under the guidance of ecosystem theory can effectively maintain nutritional status,and improve chemotherapy tolerance of ALL children.