脊柱转移瘤患者营养状况及影响因素分析

Analysis of nutritional status and nutrition related biochemical indexes in patients with spinal metastatic tumor

目的探讨脊柱转移瘤患者营养状况的影响因素并分析营养相关生化指标,为采取个体化、针对性的营养支持提供理论依据。方法选取2020年5月—2021年5月广西某三级甲等肿瘤专科医院住院治疗的101例脊柱转移瘤患者为研究对象,采用营养风险筛查2002(NRS2002)、患者日常生活能力评估表(BI)进行调查。结果脊柱转移瘤患者营养风险发生率为20.79%,年龄≥60岁的老年患者营养风险发生率(45.45%)显著高于<60岁的患者(13.92%),不同医保类型患者营养风险发生率比较,差异有统计学意义(P<0.05);此外,有营养风险的脊柱转移瘤患者BMI、HGB、ALB指标水平明显低于无营养风险患者,差异有统计学意义(P<0.05),并低于正常范围;逻辑回归分析显示,以医保类型为新农合的患者和BMI越低的患者更容易发生营养风险,新农合患者营养风险发生率是城镇医保患者的9.937倍,差异有统计学意义(P<0.05)。结论医护人员应对脊柱转移瘤患者进行营养风险筛查,同时重点关注老年患者和BMI低的群体、监测患者血红蛋白(HGB)与白蛋白(ALB)指标,宣讲发生营养风险的危害性,增强其健康自护意识,并根据相关指南为患者制订实施个体化的营养支持方案。

Objective To explore the infl uencing factors of nutritional status of patients with spinal metastatic tumor and analyze nutrition related biochemical indicators,so as to provide theoretical basis for individualized and targeted nutritional support.Methods A total of 101 patients with spinal metastatic tumor admitted in a GradeⅢClass I cancer specialized hospital in Guangxi province during May 2020 to May 2021 were selected as the research objects.Investigation applied by using nutritional risk screening 2002(NRS2002)and Barthel index(BI).Results The incidence of nutritional risk in patients with spinal metastatic tumor was 20.79%,and the incidence of nutritional risk in elderly patients≥60 years old(45.45%)was signifi cantly higher than the patients<60 years old(13.92%).The comparison of the incidence of nutritional risk in patients with diff erent medical insurance types was statistically signifi cant(P<0.05).In addition,the BMI,HGB and ALB indexes of patients with spinal metastatic tumor with nutritional risk were signifi cantly lower than those of patients without nutritional risk,the difference was statitstically significant(P<0.05)and lower than the normal range.Logical regression analysis showed the patients medical insurance were NCMS and the BMI were lower had a high occurance of nutritiondrisk,the incidence of nutritional risk in NCMS than the urban medical insurance patients,the diff erence was statistically significant(P<0.05).Conclusion Medical staffs should screen patients with spinal metastases for nutritional risk,focus on elderly patients and those with low BMI,monitor patients'hemoglobin(HGB)and albumin(ALB)indicators,develop and implement individualized nutritional support plans for patients according to relevant guidelines.