个性化营养管理在消化系统恶性肿瘤患者中的应用

Intervention and effect analysis of individualized nutrition management in patients with digestive system malignant tumor during chemotherapy

目的 观察消化系统恶性肿瘤患者化疗期个性化营养管理干预效果.方法 采用便利抽样法,纳入2014年4月―2017年4月于辽宁省肿瘤医院收治的80例消化系统恶性肿瘤患者为研究对象,按照随机数表法分为两组,每组各40例,其中对照组予以常规护理,观察组实施个性化营养管理干预,均持续干预1个月.分别于干预前及干预结束时应用营养知识、态度、行为调查问卷,评估营养知信行水平,并采用患者自评-主观全面评定量表（Patient-Generated Subjective Global Assessment,PG-SGA）、 体重、BMI、血清白蛋白（Alb）、血红蛋白（Hb）、总淋巴细胞计数（TLC）评估患者的营养状态.结果 两组干预后营养知信行（知识、态度、行为）及总量表评分高于干预前（P〈0.05）,且观察组干预后上述各维度及总量表评分均高于对照组（P〈0.05）.观察组干预后体重、BMI、Alb、Hb、TLC水平均高于干预前（P〈0.05）,PG-SGA评分低于干预前（P〈0.05）;对照组体重、BMI、Alb、TLC水平均高于干预前（P〈0.05）,PG-SGA评分低于干预前（P〈0.05）,Hb水平较干预前差异无统计学意义（P〉0.05）.观察组干预后PG-SGA评分低于对照组（P〈0.05）,上述其他指标均高于对照组（P〈0.05）.结论 对消化系统恶性肿瘤患者行化疗期个性化营养管理干预,有助于提高患者营养知信行水平,降低机体的营养风险,改善营养状态.

Objective To observe the effects of individualized nutrition management during the chemotherapy period in patients with digestive system malignant tumor. Methods A total of 80 patients with malignant tumors of digestive system admitted in Liaoning Cancer Hospital from April 2014 to April 2017 were recruited as the research object by convenience sampling method, and randomly divided into 2 groups with 40 cases in each by random number table method. The control group was given routine nursing, while the observation group received individualized nutritional intervention management for 1 month. Nutritional Knowledge, Attitude and Behavior Questionnaire was applied before and after intervention for nutritional KAP level. Patient-Generated Subjective Global Assessment （PG-SGA）, body weight （BW）, body mass index （BMI）, serum albumin （Alb）, index of hemoglobin （Hb）, total lymphocyte count （TLC）were applied to assess patients＇ nutritional status. Results The scores of KAP （knowledge, attitude and behavior） and total score of the 2 groups were significantly higher than those before intervention （P 〈 0.05）. In addition, the scores of the observation group than those of the control group after intervention （P 〈 0.05）. After intervention, BMI, Alb, BW, Hb and TLC levels of the observation group were significantly higher than those before the intervention （P 〈 0.05）, while PG-SGA score was lower than before （P 〈 0.05）. After intervention, BW, BMI, Alb and TLC of the control group were significantly higher than those before intervention （P 〈 0.05）, and PG-SGA score was lower than before （P 〈 0.05）. However, there was no statistical significance in Hb level （P 〈 0.05）. The score of PG-SGA in the observation group was significantly lower than that in the control group （P 〈 0.05）, and the other indexes were significantly higher than those in the control group （P 〈 0.05）. Conclusions Individualized nutrition management during the period of chemotherapy for patients with digestive system malignant tumor is helpful in improving the level of KAP in nutrition knowledge, reducing nutritional risk, and improving the nutritional status.