恶性肿瘤住院病人营养风险和营养支持与临床转归的研究

Research of nutritional risk,nutritional support and its relationship to clinical outcomes in patients with cancer

目的:调查恶性肿瘤住院病人营养风险的发生率,分析临床营养支持对病人营养状况和临床转归的影响。方法:收集符合纳入标准的恶性肿瘤首次住院病人526例,应用NRS 2002对其进行营养风险筛查,分析营养风险发生率,并跟踪营养支持的应用情况,比较营养支持对病人的营养状况、住院时间和临床转归的影响。结果:526例恶性肿瘤病人营养风险发生率为46.58%,且年龄越大,营养风险发生率越高(P=0.002)。NRS 2002≥3分的245例病人中,营养支持率仅59.6%,肠外营养与肠内营养应用比例为8.7∶1。给予营养支持的病人感染并发症的发生率低于无营养支持组(P=0.033),平均住院时间亦短于无营养支持组(P=0.041)。结论:恶性肿瘤住院病人的营养风险发生率较高,逐步提高肿瘤治疗中营养支持特别是肠内营养的应用率,以改善病人的临床转归,提高生存质量。

Objective： To investigate the prevalence of nutritional risk,and analyze the impact of nutritional support on nutritional status and clinical outcomes in patients with cancer. Methods： 526 cancer patients who accorded with the inclusion criteria were enrolled from November 2014 to March2015. Nutritional risk screening（ NRS） 2002 was used for analyzing the prevalence of nutritional risk.The impact of nutritional support on nutritional status,length of stay（ LOS） and clinical outcomes of the patients were observed. Results： Overall prevalence of nutritional risk was 46. 58%. The older the age was the higher the prevalence of nutritional risk reached（ P = 0. 002）. In 245 cancer patients whose NRS≥3,only 146 patients received nutritional support. The average PN∶ EN ratio was 8. 7∶1. The infection complication in patients who received nutritional support were lower than the non-received group（ P =0. 033）. LOS in nutritional support patients was shorter than the non-received group（ P = 0. 041）.Conclusion： The prevalence of nutritional risk in cancer patients is high. The nutritional support can improve the clinical outcomes and quality of the life in patients with cancer.