肿瘤患者围化疗期的营养管理进展

Progression in nutritional management of cancer patients during chemotherapy

恶性肿瘤已经成为全世界范围内研究的焦点,肿瘤患者容易出现营养不良,肿瘤相关性营养不良又是多种因素综合作用的结果,除恶性肿瘤疾病本身,20%的肿瘤患者的直接死因是营养的缺失和进行性发展的恶液质。营养不良的发生降低了机体的免疫力和抗感染能力,导致其在化疗期间的耐受性和敏感性下降,同时严重影响生活质量及预后。肿瘤患者营养风险的发生率为40%~70%,因此,早期筛查围化疗期存在营养风险的肿瘤患者,给予充分合理的营养支持,以纠正其营养不良状态,是当前需要解决的一项重大问题。围化疗期的营养治疗能够显著改善患者的营养不良状况,并对预后产生积极影响,以五阶梯营养疗法为基础的综合治疗模式逐步开展,一些新型改善营养状况的制剂与药物在临床研究和动物试验中显示出独特的疗效,大规模前瞻性的临床试验旨在探索兼顾提高营养状况与改善预后的有效手段。营养治疗贯穿抗肿瘤疗法的始终,本文分析了肿瘤患者化疗期间的营养状况及其原因,并围绕围化疗期营养疗法展开综述。

Malignancy has become the focus of studies around the world.Patients with cancer are prone to be malnourished,and cancer-related malnutrition results from multiple factors.In addition to the malignancies itself,the direct cause of death in 20% of cancer patients is nutritional deficiency and progressive cachexia.Malnutrition reduces the immunity and anti-infection ability of the body,leads to the decrease of tolerance and sensitivity during chemotherapy,and seriously affects the quality of life and prognosis.The incidence of nutritional risk in cancer patients is 40%-70%.Early screening of nutritional risks in patients with cancer during chemotherapy and giving adequate and reasonable nutritional support to change their malnutrition is a major problem to be solved at present.Numbers of studies have shown that nutritional therapy during chemotherapy can significantly improve the malnutrition status of patients and have a positive impact on the prognosis.A comprehensive treatment mode based on five-step nutrition therapy has been gradually developed.Some new supplements and drugs for improving nutritional status have shown unique efficacy in clinical studies and animal trials.Large-scale prospective clinical trials are aimed at exploring effective means to improve nutritional status and prognosis.Nutritional therapy runs through antitumor therapy,We discussed the nutritional status of cancer patients as well as the causes during chemotherapy,and nutritional support therapy in perichemotherapy was reviewed.