88例晚期肿瘤住院患者营养风险评价

Evaluating Nutritional Risk of Eighty-eight Inpatients with Advanced Tumor

目的探讨晚期肿瘤住院患者的营养风险发生情况。方法采用营养风险筛查量表（NRS2002）对88例晚期肿瘤住院患者进行营养风险筛查,采用美国东部肿瘤协作组（ECOG）分级评分评价患者体力状态,记录患者肿瘤部位、症状、中医证型及住院日,分析营养风险与ECOG分级、患者住院日的关系。结果 88例晚期肿瘤住院患者中有营养风险的患者（即NRS2002评分≥3分）42例占47.7%。消化系统肿瘤患者营养风险发生率56.8%（25/44）,其中食管癌100%（5/5）、胰腺癌100%（4/4）、胃癌66.7%（4/6）、壶腹癌66.7%（2/3）。ECOG分级3~4级者11例,其中有营养风险者占81.8%显著高于无营养风险者的18.2%（χ2=6.099,P〈0.05）。有营养风险患者平均住院日（29.2±19.1）天,显著多于无营养风险患者的（20.5±15.1）天（P〈0.05）。有营养风险的晚期肿瘤住院患者最常见的消化道症状是厌食（64.3%）、恶心呕吐（21.4%）,最常见的中医证型为脾气虚（35.7%）、湿热蕴脾（21.4%）和寒湿困脾证（19.0%）。结论晚期肿瘤住院患者营养风险发生率较高,并且ECOG分级3~4级患者营养风险发生率高,有营养风险患者住院时间相对更长。

Objective To evaluate the occurrence of nutritional risks for inpatients with advanced tumor. Methods Nutritional risks for eighty-eight inpatients with advanced tumor were screened using screening scale of nutritional risk（NRS2002）. Eastern Cooperative Oncology Group（ECOG） scale was used to evaluate patients＇ general condition,to record tumor location,syndrome,Chinese medicine syndrome,duration of hospitalization,and to analyze the relations between nutritional risk and grading of ECOG and duration of hospitalization. Result 42 inpatients had nutritional risks,（ NRS2002 ≥3 points）,accounted for 47. 7% of eighty-eight inpatients with advanced tumor. Nutritional risks occurred in 56. 8% of the inpatients with digestive system neoplasm,including 100% of patients with esophagus cancer（5 /5）,100% cases with pancreatic cancer（4 /4）,66. 7% of gastric cancer（4 /6）,and 66. 7% of ampulla cancer（2 /3）. 11 inpatients were graded as 3 to 4 with ECOG scale. Among them,81. 8% had nutritional risks,which was significantly more than those without nutritional risks（ χ2= 6. 099,P 0. 05）. The average duration of hospitalization of inpatients with nutritional risks was 29. 2 ± 19. 1 days,that was significantly longer than hospital stay of inpatients without nutritional risk（ 20. 5 ± 15. 1 days,P 0. 05）. The most common digestive symptoms in inpatients with advanced tumors and nutritional risks were asitia（64. 3%） and nausea and vomiting（21. 4%）. The most common Chinese medicine syndromes were spleen Qi deficiency（ 35. 7%）,damp-heat retention in spleen（ 21. 4%）,and cold-damp affecting spleen（19. 0%）. Conclusion Inpatients with advanced tumors and inpatients graded as 3 to4 with ECOG scale were much easier to have nutritional risks. Hospital stay of inpatients with nutritional risks is longer.