患者全面主观营养评定和营养风险筛查2002在消化系统肿瘤患者营养评估中的应用比较

Application of Nutritional Risk Screening 2002 and Patient-generated Subjective Global Assessment in Nutritional Assessment Among Digestive Tumor Patients

目的:比较营养风险筛查2002(NRS 2002)和患者全面主观营养评估(PG-SGA)在消化系统肿瘤中的应用。方法:收集2016年1月—2017年12月于十堰市太和医院住院治疗的消化系统肿瘤患者680例,分别用NRS 2002和PG-SGA评价患者营养状况,记录实验室检查结果,并分析其诊断结果的相关性。结果:消化系统肿瘤患者营养风险和营养不良发生率分别为38.2%和36.2%;不同年龄段、肿瘤类型和TNM分期的肿瘤患者NRS 2002/PG-SGA评分及营养风险/营养不良发生率差异有统计学意义,营养风险/营养不良发生率随年龄和TNM分期增加而增高,胃癌和结直肠癌高于其他类型消化系统肿瘤(P<0.05);以白蛋白(ALB)为"金标准"判断营养不良,NRS 2002和PG-SGA与ALB判断结果有较高的一致性,其约登指数分别为0.667和0.751;NRS 2002与PG-SGA判断结果一致性高,列联系数r为0.49。结论:消化系统肿瘤营养风险/营养不良发生率高,随年龄和TNM分期增加而增高,NRS 2002和PG-SGA均可用于肿瘤患者营养状况评估。

Objective To compare the application of nutritional risk screening 2002(NRS 2002)and patient-generated subjective global assessment(PG-SGA)in nutritional assessment among digestive tumor patients.Method From January 2016 to December 2017,680 patients with digestive tumor were collected from Taihe hospital of Shiyan to assess their nutritional status by NRS 2002 and PG-SGA,then laboratory indexes were recorded for next diagnosis,finally the relationship among diagnostic results were compared.Result The nutritional risk and malnutrition incidence rate were 38.2%and 36.2%among patients with digestive tumor.The differences of NRS 2002/PG-SGA score,nutritional risk/malnutrition incidence were significant with different age brackets,tumor types and TNM stages,the nutritional risk/malnutrition incidence rate were increasing with age and TNM stage,gastric cancer and colorectal cancer were significantly higher than other digestive tumors(P<0.05).Diagnosed malnutrition according to albumin as golden standard,the results of NRS 2002 and PG-SGA were highly consistent with albumin with Youden s index at 0.667 and 0.751 respectively.The results of NRS 2002 was consistent with PG-SGA with coefficient of contingency at 0.49.Conclusion The incidence rate of nutritional risk/malnutrition is high among digestive tumor patients,increasing with age and TNM stages.NRS 2002 and PG-SGA are good nutritional assessment tools for tumor patients.