三种营养状况评价法在口腔颌面恶性肿瘤患者中的比较

Comparisonsofthreesimplenutritionalassessmentsappliedtopatientswithoralandmaxilofacialmalignancies

用营养状况综合评价法（ｃｏｍｂｉｎｅｄｓｕｂｊｅｃｔｉｖｅａｎｄｏｂｊｅｃｔｉｖｅｎｕｔｒｉｔｉｏｎａｌａｓｓｅｓｓｍｅｎｔ，ＳＮＡ）、营养状况简捷评价法（ｃｏｎｃｉｓｅｎｕｔｒｉｔｉｏｎａｌａｓｓｅｓｓｍｅｎｔ，ＣＮＡ）、营养状况综合评分法（ｇｅｎｅｒａｌｎｕｔｒｉｔｉｏｎａｌｓｔａｔｕｓｓｃｏｒｅ，ＧＮＳ）及营养状况主观评价法（ｓｕｂｊｅｃｔｉｖｅｇｌｏｂａｌａｓｓｅｓｓｍｅｎｔｏｆｎｕｔｒｉｔｉｏｎａｌｓｔａｔｕｓ，ＳＧＡ）分别对１２７例口腔颌面恶性肿瘤患者进行营养状况评价。以ＳＮＡ作为标准诊断方法，对ＣＮＡ、ＧＮＳ、ＳＧＡ进行比较研究。结果显示：①ＣＮＡ的总符合率（８８．２％）明显高于ＧＮＳ（７８．０％）与ＳＧＡ（７８．７％）；②ＣＮＡ的假阳性率（９．９％）和假阴性率（１５．２％）低于ＧＮＳ（１７．３％，３０．４％）与ＳＧＡ（１４．８％，３２．６％）；③ＣＮＡ的诊断指数（７４．９％）高于ＧＮＳ（５２．３％）与ＳＧＡ（５２．６％），这种差异具有显著性（Ｐ＜０．０５）；④ＣＮＡ的评价指标均由仪器测试，避免了人为误差。

Combinedsubjectiveandobjectivenutritionalassessment(SNA),concisenutritionalassessment(CNA),generalnutritionalstatusscore(GNS),andsubjectiveglobalassessmentofnu-tritionalstatus(SGA)wereappliedtoassessthenutritionalstatusof127patientswithoralandmax-ilofacialmalignancies.OnthisbaseSNAwasusedasastandardnutritionalassessmenttocomparethevaliditiesofCNA,GNS,andSGA.Theresultsshowed:1)thetotalagreementrateofCNA(88.2%)washigherthanthatofGNS(78.0%)andSGA(78.7%);2)thefalsepositiverate(9.9%)andfalsenegativerate(15.2%)ofCNAwaslowerthanthatofGNS(17.3%,30.4%)andSGA(14.8%,32.6%);3)thediagnosisindexofCNA(74.9%)wassignificantly(P<0.05)higherthanthatofGNS(52.3%)andSGA(52.6%);and4)thenutritionalparametersofCNAweremea-suredbyinstrumentswithlitleman-madeerors.TheseresultsindicatethatCNAcanberegardedasthebestnutritionalassessmentforthepatientsinoralandmaxilofacialsurgery.