营养干预对胃部肿瘤化疗患者生活质量及依从性的影响

Effect of nutrition intervention on quality of life and chemotherapy compliance of patients with recurrence or metastasis of gastric cancer

目的探讨PG-SGA评估2~3分的复发或转移的胃部肿瘤患者化疗期间实施营养干预对患者生活质量及化疗依从性的影响。方法选取2015-06至2017-05收治的PG-SGA评估的2~3分(可疑营养不良组)复发或转移的胃部肿瘤化疗患者86例,随机分为观察组、对照组,每组43例。观察组采用饮食联合口服营养补充(oral nutritional supplements,ONS)施行营养干预,对照组采用饮食联合营养教育施行营养干预,采用欧洲肿瘤研究与治疗组织(EORTC)肿瘤患者生活质量量表(QLQ-C30)对两组患者化疗前与化疗后7~14 d的生活质量进行调查。结果观察组健康状况、躯体功能、角色功能、情绪功能、认知功能、社会功能、乏力评分较对照组高,差异均有统计学意义(P值分别为0.006、0.012、0.040、0.039、0.028、0.017、0.006;P<0.05);观察组患者化疗减量、延迟化疗、中止化疗的比例均明显低于对照组,差异有统计学意义(P<0.05)。结论基于PG-SGA的2~3分的复发或转移的化疗胃部肿瘤患者实施饮食联合口服营养补充的营养干预措施较饮食联合营养教育的营养干预措施更能提高患者总体生活质量,改善其乏力症状,提高患者的躯体功能,提高患者化疗依从性。

Objective To investigate the effect of nutritional intervention on quality of life and chemotherapy compliance of patients with relapsed or metastatic gastric cancer and with PG-SGA scores ranging from 2 to 3 during chemotherapy. Methods A total of 86 patients with recurrent or metastatic gastric cancer who had got 2-3 points according to the PG-SGA method and received treatment between June 2015 and May 2017 were enrolled in this study,who were randomly divided into the observation group and control group（ n = 43）. The control group was treated with diet combined with oral nutritional supplements（ ONS）,while the control group was treated with diet combined with dietary nutrition education. The EORTC（ European Organization for Research on Treatment of Cancer）cancer patients＇ quality-of-life scale（ QLQ-C30） was used to evaluate the quality of life of these patients before chemotherapy and after7 to 14 days of chemotherapy. Results Scores of general health,physical function,role function,emotional function,cognitive function,social function and fatigue were significantly different between the two groups（ t = 0. 006,0. 012,0. 040,0. 039,0. 028,0. 017,0. 006; P〈0. 05）. The proportion of reduced chemotherapy,delayed chemotherapy and discontinuation of chemotherapy in the observation group was significantly lower than that of the control group（ P〈0. 05）. Conclusions Diet combined with oral nutrition can improve the quality of life of patients with recurrent or metastatic gastric cancer and with PG-SGA scores of 2 to 3 more significantly than diet combined with diet nutrition education,leading to less fatigue,better physical function and higher compliance with chemotherapy.