食管癌术后康复期患者营养状况及生命质量的纵向研究

Longitudinal study of nutrition and quality of life in patients with postoperative recovery of esophageal cancer

目的 了解食管癌术后康复期患者营养状况及生命质量的变化趋势及相关关系.方法 以四川省肿瘤专科医院行食管癌手术治疗的75例患者为研究对象,在患者术后1个月、3个月和6个月时运用患者主观整体营养评估量表进行营养评估,采用肿瘤生命质量测评量表和食管癌患者补充量表进行生命质量评定.结果 食管癌患者术后随时间的延长营养不良发生率由73.4%下降至33.5%.生活质量各维度评分在各评估时间点差异均有统计学意义(P<0.05),功能领域和症状领域在术后1个月与术后3个月、术后6个月比较有统计学意义(P<0.05),术后3个月与术后6个月比较差异无统计学意义(P>0.05).患者营养状态与躯体、角色、情绪及社会功能呈负相关(P<0.05),与吞咽困难、进食、反流、梗阻、食欲减退、咳嗽症状呈正相关(P<0.05).结论 食管癌术后1个月患者营养状况及生命质量较差,随时间推移逐渐好转.医护人员应根据患者在不同时间点营养状况及生命质量的变化特点,制定规范化和个体化的延续护理方案,以促进患者术后康复、提高生命质量.

Objective To understand the trend and correlation of nutrition status and quality of life in patients with esophageal cancer during postoperative rehabilitation period,so as to provide reference for the development of postoperative extended care plan for esophageal cancer.Methods Seventy-five patients who underwent esophageal cancer surgery in Sichuan Cancer Hospital were selected as subjects.The patient-generated subjective global assessment scale(PG-SGA),the European Organization For Research and Treatment of Cancer QOL Cancer Specific Version(EORTC QLQ-C30)and the Esophageal Cancer Supplemental Scale(EORTC QLQ-OES18)were used for assessment at 1month,3 months and 6months after surgery.Results The incidence of malnutrition in patients with esophageal cancer decreased from 73.4%to 33.5%with time.Quality of life in each evaluation time point had statistical significance(P<0.05),the comparative difference of function areas and symptoms in postoperative 1month,3 months,and 6months was notably significant(P<0.05),whereas there was no difference between postoperative 3 months and 6months(P>0.05).Moreover,Nutritional status was negatively correlated with body,role,mood and social function(P<0.05),and positively correlated with dysphagia,eating,reflux,obstruction,anorexia and cough(P<0.05).Conclusions The nutrition and quality of life in patients with esophageal cancer are poor during the first month after operation,and gradually improve over time.In order to improve the quality of life of patients during rehabilitation,medical staff should develop a standardized and individualized extended care plan according to the changes of nutritional status and quality of life at different time points.