卫辉地区初诊食管癌患者营养状态及影响因素研究

Nutritional status and its influencing factors of newly diagnosed patients with esophageal cancer in Weihui region

目的调查初诊食管癌患者营养状态及影响因素,为制订营养支持干预措施、改善患者预后提供依据。方法对2020年1月至2021年12月在新乡医学院第一附属医院初诊食管癌患者进行营养状态及影响因素调查,采用微型营养评估表(MNA)进行营养状态评估,采用中文版记忆症状评估量表(MSAS)对患者症状进行评估,采用描述性分析方法对初诊食管癌患者营养风险进行分析,并对营养状态影响因素进行单、多因素分析。结果共541例初诊食管癌患者,营养正常196例(36.23%)、存在营养不良风险236例(43.62%)、营养不良109例(20.15%)。初诊食管癌患者MSAS量表生理症状(2.03±0.49)分,心理症状(1.02±0.25)分,总困扰指数(1.16±0.31)分,MSAS总分(1.28±0.39)分。多因素Logistic回归分析提示年龄(OR=1.412)、饮食习惯(OR=2.768)、食管癌分段(OR=3.658)、食管癌分期(OR=4.586)、生理症状(OR=1.775)、心理症状(OR=2.171)、总困扰指数(OR=2.712)及MSAS总分(OR=1.119)是初诊食管癌患者营养状态的影响因素。结论卫辉地区初诊食管癌患者多存在营养不良风险,应针对患者症状进行全面评估并综合其他营养状态影响因素采取个体化且高效的干预措施,提高患者生活质量。

Objective To investigate the nutritional status and its influencing factors of newly diagnosed patients with esophageal cancer,to provide a reference for the formulation of nutritional support interventions and to improve patient outcomes.Methods The nutritional status and its influencing factors of newly diagnosed patients with esophageal cancer at the First Affiliated Hospital of Xinxiang Medical College were investigated from January 2020 to December 2021.The nutritional status was evaluated by using the Mini-Nutritional Assessment form(MNA),and the symptoms were evaluated by using the Chinese version of the Memorial Symptom Assessment Scale(MSAS).The nutritional risk of newly diagnosed patients with esophageal cancer was analyzed using a descriptive analysis,with a univariate and multivariate analysis of the influencing factors of nutritional status.Results There were 541 newly diagnosed patients with esophageal cancer,of which 196(36.23%)had normal nutrition,236(43.62%)had risk of malnutrition,and 109(20.15%)had malnutrition.In the MSAS of newly diagnosed patients with esophageal cancer,the scores of physiological symptoms,psychological symptoms,total distress index,and total MSAS were(2.03±0.49),(1.02±0.25),(1.16±0.31),and(1.28±0.39)respectively.Multivariate Logistic regression analysis indicated age(OR=1.412),dietary habits(OR=2.768),segmentation of esophageal cancer(OR=3.658),stage of esophageal cancer(OR=4.586),physiological symptoms(OR=1.775),psychological symptoms(OR=2.171),total distress index(OR=2.712),and total score of MSAS(OR=1.119)were the factors affecting the nutritional status of newly diagnosed patients with esophageal cancer.Conclusions Most newly diagnosed patients with esophageal cancer in the Weihui region are at risk of malnutrition.Therefore,a comprehensive assessment should be carried out based on the patient's symptoms,and individualized and efficient intervention measures should be taken in combination with other factors affecting the nutritional status to improve the quality of life of the patient.