老年胃肠道恶性肿瘤患者围术期营养不良和营养风险状况评估及营养支持的合理性应用

Assessment of malnutrition and nutritional risk in patients with elderly gastrointestinal cancer and the rationality in application of nutrition support

目的探究患有胃肠道恶性肿瘤的老年患者围术期的营养不良和营养风险的发生情况以及应用营养支持的合理性。方法选取2014年1月～2016年1月温州医科大学附属第一医院收治的80例老年胃肠道恶性肿瘤患者作为研究对象，整理患者相关临床资料。在围术期对患者的营养不良、营养风险以及营养支持情况进行连续抽样调查。结果老年胃肠道恶性肿瘤中胃癌和结肠癌患者发生营养不足的比率较高，分别为35.00%和40.00%，差异具有统计学意义（χ2=8.490，P=0.014）；存在营养风险的患者有34例（占总数42.50%），其中胃癌患者50.00%，结肠癌为45.00%，直肠癌为42.86%，肝癌为37.50%，胰腺癌为36.75%，胃间质瘤为21.43%。所有患者中共有33例患者在围术期接受了营养支持治疗，约占41.25%，且接受营养支持治疗的患者中肠外营养和肠内营养的比率为2.25:1。结论老年胃肠道恶性肿瘤患者围术期营养不良和营养风险的发生率较高，临床上营养支持治疗的应用还有不合理的地方，需要进一步改进。

Objective To explore the occurrence of malnutrition and nutritional risk in patients with elderly gastrointestinal cancer and the application of clinical nutrition support in these patients.Methods80old patients with gastrointestinal cancer in the first affiliated hospital of Wenzhou medical university from January2014to January2016were selected as research samples.The situation of malnutrition,nutritional risk and nutrition support in perioperative period were investigated by continuous sampling method.Results The proportions of patients with colon cancer and gastric cancer were35.00%and40.00%,which were higher than others,the difference was statistically significant(χ2=8.490,P=0.014).There were34patients(42.50%)with nutrition risk,among which the proportion of patients with colon cancer was50.00%,gastric cancer was45.00%,liver cancer was42.86%,esophageal cancer was37.50%,pancreatic cancer was36.75%and rectal cancer was21.43%.Nutrition support was provided to33patients,accounting for41.25%,among which the proportion of parenteral nutrition and enteral nutrition was2.25:1.Conclusion The rates of malnutrition and nutritional risk were high in patients with elderly gastrointestinal cancer in perioperative period,and the application of nutrition support was somewhat inappropriate in the hospital,which needs to be further improved.