阿片类药物治疗中重度癌痛病人的营养状况及影响因素分析

Nutritional status and its related factors in opioids-treated patients with moderate to severe cancer pain

目的:统计使用阿片类药物止痛的中重度癌痛病人营养不良的发生率,分析影响以上群体病人营养不良的相关因素。方法:回顾性分析2013年7月至2018年7月符合纳入标准的中重度癌痛住院病人,通过NRS 2002对其进行营养风险筛查,再评估其营养状况,同时对这些病人的临床资料、癌痛控制情况以及肿瘤治疗情况进行总结,分析影响营养不良的因素。结果:共216例中重度癌痛病人纳入研究,其中营养风险发生率59.3%,营养不良发生率35.2%,多因素Logistic回归分析显示疼痛控制情况是影响使用阿片类药物止痛的中重度癌痛病人营养不良的独立危险因素。结论:使用阿片类药物止痛的中重度癌痛病人营养不良发生率高,特别是疼痛控制不佳的癌痛病人,对于此类病人应及时、积极地给予病人营养支持治疗。

Objective:To investigate the nutritional status in patients suffering from moderate to severe cancer pain treated with opioid analgesics,and to analyze the risk factors associated with malnutrition in this population.Method:We retrospectively analyzed 216 cancer patients enrolled from July 2013 to July 2018.Nutritional risk screening 2002(NRS 2002)was used to analyze the prevalence of nutritional risk.Nutritional status was determined according to the malnutrition criteria from ESPEN Consensus Statement.Patients’demographics,methods for cancer pain control and the treatment of primary cancer were summarized,and the factors affecting malnutrition were analyzed.Results:A total of 216 patients with moderate to severe cancer pain were included in this study.The incidence of nutritional risk and malnutrition were 59.3%and 35.2%,respectively.Multivariate logistic regression analysis revealed that sufficiency of pain control was independent risk factor for malnutrition in patients with moderate to severe cancer pain.Conclusion:There was a high incidence of malnutrition in patients using opioids with moderate to severe cancer pain.In particular,for cancer patients with poorly pain control,nutritional support should be timely and actively performed.