胃癌术后患者化疗致恶心呕吐程度及其影响因素分析

Severity of CINV in patients with gastric cancer undergoing chemotherapy and its influencing factors

目的探讨胃癌化疗患者的膳食质量情况及其对化疗致恶心呕吐(CINV)严重程度的影响,为指导胃癌患者化疗期间合理膳食提供依据。方法采用膳食质量评价法和美国国家癌症研究所(NCI)CINV分级对2020年4—10月在新疆医科大学附属肿瘤医院消化内科住院接受奥沙利铂联合替吉奥方案进行术后辅助化疗的110例胃癌患者进行调查,分析胃癌患者CINV分级的影响因素。结果胃癌患者膳食质量总体合格率为39.09%。不同年龄、性别、文化程度、化疗周期、心理状态、营养风险筛查(NRS)评分、膳食质量的胃癌患者CINV分级比较,差异均有统计学意义(P<0.05)。Logistic回归分析结果显示,胃癌患者的心理状态、化疗周期、NRS评分和膳食质量是CINV分级的主要影响因素(P<0.05)。结论心理状态、化疗周期、NRS评分和膳食质量可影响胃癌患者CINV的严重程度,应进一步针对胃癌患者的膳食结构、膳食质量等问题及时开展营养健康教育,改良患者膳食模式,减轻和改善患者化疗致恶心呕吐症状。

Objective To analyze the dietary quality of patients with gastric cancer undergoing chemotherapy and its influence on severity of nausea and vomiting induced by chemotherapy,so as to provide a basis for guiding the rational diet in patients with gastric cancer during chemotherapy.Methods 110 patients with gastric cancer who received oxaliplatin combined with teggio regimen for postoperative adjuvant chemotherapy in the hospital from April to October 2020 were investigated,and the influencing factors with CINV grade of gastric cancer patients were analyzed.Dietary quality evaluation method and CINV classification of National Cancer Institute(NCI)were used.Results The overall qualified rate of dietary quality in patients with gastric cancer was 39.09%.The CINV grades of gastric cancer patients with different age,gender,educational level,chemotherapy cycle,psychological state,NRS score and dietary quality were significantly different(P<0.05).Logistic regression analysis showed that psychological state,chemotherapy cycle,NRS score and dietary quality of the patients with gastric cancer were main influencing factors of CINV grade(P<0.05).Conclusion Mental state,chemotherapy cycle,NRS score and dietary quality can affect severity of CINV in patients with gastric cancer.Nutritional health education should be carried out in time to further address dietary structure and dietary quality of the patients with gastric cancer,to improve the dietary mode of patients and to improve the symptoms of nausea and vomiting caused by chemotherapy.