护士主导的多学科协作营养管理方案在胃肠道肿瘤患者辅助化疗中的应用

Application of Nurse-Led Multidisciplinary CollaborativeNutritional Management in Adjuvant Chemotherapyfor Gastrointestinal Tumors

目的 探讨护士主导的多学科协作营养管理方案在胃肠道肿瘤患者辅助化疗中的应用效果。方法 选取2021年1—10月在南昌大学第一附属医院行XELOX方案辅助化疗的68例胃肠道肿瘤患者为研究对象,按入院治疗顺序单双号分为对照组和观察组,每组34例。对照组实行常规营养管理,观察组在对照组的基础上实行护士主导的多学科团队协作营养管理方案,分别在入院时、化疗1次、化疗3次和化疗6次后比较2组患者营养学指标[包括白蛋白、血红蛋白、球蛋白及总蛋白水平,体重指数(BMI),NRS 2002营养评分和整体评估量表(PG-SGA)评分]、化疗不良反应(血液毒性、胃肠道反应、手足综合征、周围神经病理性疼痛)和生活质量[采用欧洲生命质量协作组癌症核心量表(EORTC QLQ-C30)及卡氏评分(KPS)评分评价]。结果 入院时和化疗1次后2组各项营养学指标及EORTC QLQ-C30、KPS评分比较差异无统计学意义(P>0.05),化疗1次后2组化疗不良反应比较差异无统计学意义(P>0.05);化疗3次和化疗6次后观察组各项营养学指标、化疗不良反应及EORTC QLQ-C30、KPS评分显著优于对照组(P<0.05)。结论 护士主导的多学科协作营养管理方案可提高胃肠道肿瘤患者生活质量,改善营养状况,减轻化疗不良反应。

Objective To explore the efficacy of nurse-led multidisciplinary collaborative nutrition management program in patients undergoing adjuvant chemotherapy for gastrointestinal tumors.Methods A total of 68 patients with gastrointestinal tumors who received adjuvant chemotherapy with XELOX regimen in the First Affiliated Hospital of Nanchang University from January to October 2021 were selected as the research objects.According to the order of admission,these patients were given routine nutrition management alone(control group,34 cases)or in combination with nurse-led multidisciplinary collaborative nutrition management(observation group,34 cases).The nutritional indexes(albumin,hemoglobin,globulin and total protein levels,body mass index(BMI),NRS 2002 Nutrition score,and Patient-Generated Subjective Global Assessment(PG-SGA)score),chemotherapy-related adverse reactions(hemotoxicity,gastrointestinal reactions,hand-foot syndrome,and peripheral neuropathic pain),and quality of life(The European Organization for Research and Treatment of Cancer Quality of Life Questionnaire(EORTC QLQ-C30)and Karnofsky Performance Status(KPS)scores)were compared between the two groups at admission and after 1,3 and 6 times of chemotherapy.Results There were no significant differences between the two groups in the nutrition indexes,EORTC QLQ-C30 score and KPS score at admission and after 1 time of chemotherapy,as well as in the chemotherapy-related adverse reactions after 1 and 2 times of chemotherapy(P>0.05).However,compared with the control group,the nutritional indexes,chemotherapy-related adverse reactions and scores of EORTC QLQ-C30 and KPS were significantly improved in the observation group after 3 and 6 times of chemotherapy(P<0.05).Conclusion Nurses-led multidisciplinary collaborative nutrition management program can enhance quality of life,improve nutritional status,and reduce chemotherapy-related adverse reactions in patients with gastrointestinal tumors.