肿瘤病人营养状况调查及其影响因素分析

Investigation of the nutritional status and its influencing factors in tumor patients

目的:对肿瘤病人营养状况进行调查并分析其影响因素。方法:应用患者主观整体评估(patient-generated subjective global assessment,PG-SGA)法对2014年2月至2016年8月在安徽省肿瘤医院放化疗科住院治疗的996例肿瘤病人入院48 h内完成营养评估。并将其分为营养状况良好(PG-SGA A级)、可疑或中度营养不良(PG-SGA B级)、重度营养不良(PG-SGA C级)3组;其中PG-SGA A级归为无营养不良组、PG-SGA B级与PG-SGA C级归为营养不良组,并收集病人基本信息及各项客观营养指标,分析各因素与营养不良的相关性。结果:共959例恶性肿瘤病人纳入研究,其中PG-SGA A级366例(38.2%)、PG-SGA B级268例(28.0%)、PG-SGA C级325例(33.9%),营养不良发生率为61.8%。多因素logistic回归分析结果显示:放疗(OR=1.629)、体质量指数大(OR=11.769)、低蛋白血症(OR=10.982)和非利手(或非损伤手)握力(OR=1.060)是恶性肿瘤发生营养不良的独立危险因素(P<0.05~P<0.01),而女性(OR=0.164)、年轻(OR=0.958)、无口干(OR=0.038)、无早饱(OR=0.053)是保护因素(P<0.01)。结论:营养不良是恶性肿瘤病人常见的问题,应尽早对恶性肿瘤病人进行营养筛查。

Objective:To investigate the nutritional status,and analyze the influencing factors in cancer patients.Methods:The nutritional status of 996 tumor patients from the departments of radiotherapy and chemotherapy of Anhui Provincial Tumor Hospital from February 2014 to August 2016 were evaluated using the patient-generated subjective global assessment(PG-SGA)within 48 h of admission.The patients were divided into the good nutrition(stage PG-SGA A)group,suspected or moderate malnutrition(stage PG-SGA B)group and severe malnutrition(stage PG-SGA C)group.The stage PG-SGA A was classified as the non-malnutrition group,and the stage PG-SGA B and C were classified as malnutrition group,the basic information and various objective nutritional indicators of patients were collected to analyze the correlation between each factor and malnutrition.Results:Among 959 tumor patients,the stage PG-SGA A in 366 cases(38.16%),stage PG-SGA B in 268 cases(27.95%)and stage PG-SGA C in 325 cases(33.89%)were identified,and the incidence rate of malnutrition was 61.84%.The results of multivariate logistic regression analysis showed that the radiotherapy(OR=1.629),booly mass index(OR=11.769),hypoproteinemia(OR=10.982)and grip strength(OR=1.060)were the independent risk factors of malnutrition(P<0.05 to P<0.01),and the female(OR=0.164),youth(OR=0.958),no dry mouth(OR=0.038),and premature satiation(OR=0.053)were the protective factors(P<0.01).Conclusions:Malnutrition is a common problem in patients with malignant tumors.The nutritional screening should be conducted as early as possible in patients with malignant tumors.