肿瘤住院病人营养治疗现状多中心调查报告

A comprehensive nutritional survey of oncology inpatients

目的分析肿瘤住院病人的营养状况、营养治疗现状及意义。方法分析2016年中国"世界营养日"调查数据,纳入来自中国华北、华南、西北及西南地区的8家大型三甲医院肿瘤住院病人共306例,收集并分析其疾病信息、营养治疗及30 d预后信息。结果该306例住院病人营养风险及营养不良总发生率为51.3%(157/306),其中营养不良发生率为35.3%(108/306),其中肠外营养应用率达45.8%(140/306)。74.4%(218/293)的病人能从营养治疗中获益。营养支持可明显改善有营养风险或营养不良肿瘤病人的30 d预后,但对营养状况良好者效果不明显。33.3%的营养不良的肿瘤病人和46.9%的存在营养风险的肿瘤病人没有接受营养干预,而营养状况良好的肿瘤病人被施以营养治疗的比例高达51.0%。病人营养状况、住院期间手术、自评健康状况是我国肿瘤住院病人30 d预后的危险因素。结论我国肿瘤住院病人营养风险及营养不良发生率高,营养支持实施不够规范,对于自评健康状况差、晚期肿瘤失去手术机会、营养状况差的肿瘤病人应及时制定针对性治疗措施。

Objective To provide a comprehensive description of the nutritional characteristics, nutritional support and its importance among oncology inpatients. Methods The data from Nutrition Day 2016 about 306 oncology inpatients from 8 domestic hospitals were enrolled. Information of nutrition support and 30-day outcomes were collected and analyzed. Results The incidence of nutritional risk or malnutrition in oncology inpatients was 51.3qv （157/306）. Among them, malnutrition rate was 35.3% （ 108/306）, and parenteral nutrition using rate was 45.8% （140/306）. About 74.4% （218/293） patients believed they could benefit from the nutrition therapy. The nutrition therapy improved 30-day outcomes of oncology inpatients with nutritional risk or malnutrition, but had no effect on those well nourished. And 33.3% of malnutrition patients and 46.9% of patients with nutritional risk did not receive nutritional support, whereas 51.0% well-nourished patients did. Nutritional status, operation during hospital stay and self-rated health were risk factors of 30-day outcomes for oncology inpatients. Conclusion The prevalence of nutritional risk and malnutrition is still high and associated with poor 30-day outcomes. Nutritional treatment is not standardized enough in domestic hospitals. Specific interventions should be considered for oncology inpatients with poor self-rated health, lost operation opportunity and poor nutrition status in terminal stage.