PG-SGA主导的营养干预对鼻咽癌放化疗患者的效果评价

Effects of PG-SGA guided nutritional intervention on nasopharyngeal carcinoma patients undergoing chemoradiotherapy

目的探讨以患者主观整体评估量表(PG-SGA)为主导的营养干预在鼻咽癌放化疗患者中的应用效果。方法选取2019年9月—2020年11月收治的初治鼻咽癌同期放化疗患者,共60例。将上述患者分为试验组和对照组。试验组给予PG-SGA评估,分级达到B级≥2分,即实施个体化强化营养咨询和口服营养补充,对照组常规给予营养咨询和口服营养补充。比较2组患者入院时、放疗20次时、放疗结束时的体重指数(BMI)、白蛋白(Alb)、血红蛋白(Hb)及放疗毒副反应。结果放疗前,2组患者PG-SGA评分、BMI、Alb和Hb比较,差异无统计学意义(P>0.05)。放疗至20次与放疗结束时,2组PG-SGA评分均上升,BMI均下降,Alb和Hb水平均有下降,且试验组结果优于对照组(P<0.05)。放疗结束时,2组患者口干症状的评分比较,差异无统计学意义(P>0.05),而试验组放射性皮炎、口腔黏膜炎的评分低于对照组(P<0.05)。结论以PG-SGA评估为主导的营养干预能改善患者的营养状况、降低鼻咽癌急性放射损伤。

Objective To evaluate the application of the Patient Generated Subjective Global Assessment(PG-SGA)scale on nasopharyngeal carcinoma(NPC)patients with chemoradiotherapy.Methods A total of 60 NPC patients who received concurrent chemoradiotherapy from September 2019 to November 2020 were selected.They were randomly divided into two groups:a control group and an experimental group.The experimental group was assessed by PG-SGA scale,and individualized enhanced nutrition counseling and oral nutritious supplements were prescribed to the patients with grade B≥2.Patients in the control group were given routine nutritional counseling and oral nutritional supplementation.Both groups were compared for body weight index(BMI),Alb and Hb at admission,after radiotherapy for 20 times,and at the end of radiotherapy.Meanwhile,the acute radiological toxic and side effects were recorded at the end of radiology.Results Before radiotherapy,there were no statistical differences in PG-SGA score,BMI,Alb and Hb between the two groups(P>0.05).After radiotherapy for 20 times and at the end of radiotherapy,both groups presented increases in PG-SGA scores,decreases in BMI and decreases in Alb and Hb,where the experimental group has better results than the control group(P<0.05).There was no statistical difference in the score of xerostomia between the two groups at the end of radiotherapy(P>0.05),and the scores of radiation dermatitis and oral mucositis of patients in the experimental group were lower than those of the control group(P<0.05).Conclusions Nutritional intervention assessed by PG-SGA can significantly reduce the acute radiation toxicity and improve the nutritional condition,quality of life and treatment compliance of NPC patients during chemoradiotherapy.