鼻腔NK/T细胞淋巴瘤住院病人营养风险和营养支持现状调查

Survey on nutritional risk and nutritional support status of inpatients with nasal NK/T-cell lymphoma

[目的]了解鼻腔自然杀伤(NK)/T细胞淋巴瘤病人放化疗期间的营养风险以及临床营养支持的现状。[方法]选择湖南省某专科肿瘤医院于2009年12月—2016年9月收治的鼻腔NK/T细胞淋巴瘤放化疗病人151例为研究对象,调查病人放化疗期间的不良反应和临床生化检测结果,同时使用营养风险筛查简表(NRS 2002)进行营养风险筛查,并进行临床营养支持状况调查。[结果]病人在住院过程中上消化道反应、口腔反应和白细胞下降等不良反应普遍存在,营养相关的血液生化指标明显恶化。病人在出院时体重、体质指数(BMI)低于入院时,出院时营养风险筛查评分高于入院时,入院和出院时有营养风险的病人分别为38例(25.2%)和130例(86.1%)。97例(64.2%)在治疗过程中接受过肠外营养支持,12例(7.9%)接受过肠内营养制剂支持,肠外营养治疗和肠内营养治疗的临床应用比例为8.1∶1。33例(21.9%)病人出院时NRS2002评分≥3分,尽管存在营养风险,但不曾接受营养支持。[结论]鼻腔NK/T细胞淋巴瘤病人在放化疗期间消化道反应、口腔反应和白细胞下降等普遍存在,有明显的营养不良风险,因此需加强病人住院期间的营养支持。临床营养支持的应用存在一定的不合理,建议临床医务人员根据中国肿瘤营养治疗指南,在治疗前和治疗期间给予病人适当的营养支持和必要的营养健康教育。

Objective:To investigate the nutritional risk and the application of nutritional support in inpatients with nasal natural killer (NK)/T-cell lymphoma.Methods:One hundred and fifty-one patients with nasal NK/T cell lymphoma were enrolled in this study from November 2009 to September 2016 in a specialist tumor hospital in Hunan province.The adverse reactions and clinical biochemical tests were investigated in patients during chemoradiotherapy.Nutritional Risk Screening (NRS) 2002 was used for nutrition risk screening.The status of clinical nutritional support was investigated.Results:During the hospitalization,adverse reactions such as upper gastrointestinal reactions,oral reactions and leukopenia were common,and nutrition-related blood biochemical indicators were deteriorated.The weight and body mass index (BMI) at discharge were lower than that at admission.NRS2002 scores were higher compared with admission.There were 38 cases (25.2%) and 130 cases (86.1%) of nutritional risk at the time of admission and discharge.Ninety-seven cases (64.2%) received parenteral nutrition support,12 cases (7.9%) received enteral nutrition support.The ratio of parenteral nutrition and enteral nutrition was 8.1:1.Thirty-three (21.9%) patients were discharged from the hospital with NRS 2002 scores were ≥3,despite nutritional risks,they did not receive nutritional support.Conclusion:During the period of chemoradiotherapy patients with nasal NK/T-cell lymphoma were prevalent with gastrointestinal reactions,oral reactions and leukopenia,and there is a significant risk of malnutrition.Therefore,it is necessary to strengthen the nutritional support during hospitalization.There are some unreasonable applications of clinical nutrition support.It is recommended that clinicians provide patients with appropriate nutritional support and necessary nutrition and health education during hospitalization,as recommended by the Chinese Cancer Nutrition Therapy Guidelines.