老年消化道恶性肿瘤患者营养不良影响因素分析及肠内外营养支持干预效果

Analysis of influencing factors of malnutrition in elderly patients with gastrointestinal malignant tumors and the intervention effects of enteral and parenteral nutrition support

目的分析老年消化道恶性肿瘤患者营养不良的影响因素,并探讨肠内外营养支持的干预效果。方法选取2017年1月—2019年1月我院收治的消化道恶性肿瘤患者249例,采用患者自评-主观全面评定(PG-SGA)量表评估患者营养状况,统计营养不良的发生情况;多因素Logistic回归分析老年消化道恶性肿瘤患者营养不良的影响因素,对营养不良患者给予肠内外营养支持干预,对比干预前后患者营养指标、免疫功能指标及生活质量的变化。结果249例患者中发生营养不良167例,发生率为67.07%;多因素Logistic回归分析显示,年龄(OR=0.681,95%CI:1.418~3.613)、BMI(OR=6.451,95%CI:4.253~8.212)、既往营养不良史(OR=1.631,95%CI:3.219~6.032)是老年消化道恶性肿瘤患者营养不良的独立影响因素(P<0.05);肠内外营养支持干预后,患者的营养指标、免疫功能指标及生活质量均明显改善(P<0.05)。结论老年消化道恶性肿瘤患者营养不良的影响因素较多,给予肠内外营养支持干预可有效改善患者的营养指标、免疫功能,提升其生活质量。

Objective To analyze the influencing factors of malnutrition in elderly patients with gastrointestinal malignant tumors,and to explore the effects of enteral and parenteral nutrition supports.Methods A total of 249 patients with gastrointestinal malignant tumors admitted to our hospital between January 2017 and January 2019 were selected.The Patient-Generated Subjective Global Assessment(PG-SGA)scale was used to assess the nutritional status of patients,and the incidence of malnutrition was counted.Multivariate Logistic regression was used to analyze the influencing factors of malnutrition.Enteral and parenteral nutrition supports were given to malnourished patients,and the changes of nutrition indicators,immune function indicators,and quality of life before and after intervention were compared.Results Among the 249 patients,167 cases had malnutrition,and the incidence rate was 67.07%.Multivariate Logistic regression analysis showed that age(OR=0.681,95%CI=1.418~3.613),BMI(OR=6.451,95%CI=4.253~8.212),previous malnutrition(OR=1.631,95%CI=3.219~6.032)were independent influencing factors of malnutrition in elderly patients with gastrointestinal malignant tumors(P<0.05).After enteral and parenteral nutrition intervention,the nutritional indicators,immune function indicators and quality of life of patients were significantly improved(P<0.05).Conclusion There are many factors resulting in malnutrition in elderly patients with gastrointestinal malignant tumors.Enteral and parenteral nutrition support interventions can effectively improve their nutritional indicators,immune function,and improve the quality of life.