胃癌根治术后患者化疗期营养风险的动态评估及饮食指导启示

Nutritional risk assessment and dietary guidance in postoperative patients with gastric cancer on chemotherapy

目的调查胃癌根治术后患者化疗期的营养状况,为患者提供及时有效的饮食指导提供依据.方法选取从2014-09/2016-03在郑州大学第一附属医院胃肠外科行胃癌根治性切除术后接受完整化疗的患者,每次化疗入院后48 h内进行营养状况相关评估,填写患者主观整体营养状况评量表,化疗结束后填写胃癌患者化疗不良反应调查问卷,对化疗期患者化疗初期、化疗中期、化疗结束时进行动态营养评估.结果患者化疗前期、中期、后期的营养不良发生率分别为56.3%、66.02%、73.79%,不同阶段的营养状况差异有统计学意义(P<0.05);食欲减退是发生率最高的化疗不良反应,化疗前期、中期、后期的发生率分别为:34.95%、56.31%、75.73%;患者获取饮食知识的途径主要为医护人员,化疗前期、中期、后期的所占比例分别为:92.23%、79.61%、75.73%.结论胃癌根治术后患者随着化疗进行营养状况越来越差,建议医护人员针对患者的营养状况及时给予饮食指导,改善患者的营养状况提高疾病预后.

AIM To investigate the nutritional status of postoperative patients with gastric cancer on chemotherapy and to provide timely dietary guidance and nutritional support for these patients.METHODS Patients who received curative resection for gastric cancer and were on chemotherapy at Department of Gastrointestinal Surgery of the First Affiliated Hospital of Zhengzhou University from September 2014 to March 2016 were included.The patients were assessed by unified training investigators within 48 h after hospitalization.The questionnaires such as the Scored Patient-Generated Subjective Global Assessment（PG-SGA） and the Chemotherapy Side Effects of Patients with Gastric Cancer Questionnaire were used to assess the nutritional status of patients.RESULTS The difference in the nutritional status of patients on different stages of chemotherapy was statistically significant（P 〈 0.05）.With the increase in the number of chemotherapy cycles,the nutritional status of patients became worse.Anorexia was the most common dietrelated symptom,and the rates of anorexia in patients on early,medium and late stages of chemotherapy were 34.95%,56.31%,and75.73%,respectively.Patients acquired diet knowledge mainly from medical staff.The proportions of patients who acquired diet knowledge from medical staff on early,medium and late stages of chemotherapy were92.23%,79.61%,and 75.73%,respectively.CONCLUSION With the increase in the number of chemotherapy cycles,the nutritional status of patients becomes worse.Medical staff should provide timely,effective dietary guidance to improve the nutritional status and clinical outcome of patients.