“H2H”营养管理模式对食管癌放疗患者营养状态及生命质量的影响

Effects of‘H2H’nutrition management model on nutritional status and quality of life of patients with esophageal cancer undergoing radiotherapy

目的:探讨“从医院到家庭(H2H)”营养管理模式对食管癌放疗患者营养状态及生命质量的影响。方法:选取2018年1月至2020年6月该院收治的92例食管癌放疗患者进行前瞻性研究,按照随机数字表法分为观察组和对照组各46例。对照组实施常规营养干预,观察组在对照组基础上实施“H2H”营养管理模式干预。比较干预前后两组主观整体营养状况评估量表(PG-SGA)评分、营养指标[血清前白蛋白(PA)、转铁蛋白(TRF)]水平、癌因性疲乏状况[Piper疲乏量表(PFS)]、生命质量[癌症病人生活功能指标量表(FLIC)],以及不良事件发生率。结果:观察组干预后血清TRF、PA水平及心理良好、躯体良好和能力、社会良好维度评分均高于对照组,因癌造成的艰难、恶心维度评分、PG-SGA评分、PFS评分及不良事件发生率均低于对照组,差异有统计学意义(P<0.05)。结论:“H2H”营养管理模式应用于食管癌放疗患者可改善其营养状况,降低癌因性疲乏程度及不良事件发生率,提高生命质量。

Objective:To explore effects of“hospital-to-home(H2H)”nutrition management model on nutritional status and quality of life of patients with esophageal cancer undergoing radiotherapy.Methods:A prospective study was conducted on 92 patients with esophageal cancer undergoing radiotherapy in the hospital from January 2018 to June 2020.They were divided into observation group and control group according to the random number table method,46 cases in each.The control group received routine nutritional intervention,while the observation group received“H2H”nutritional management model on the basis of that of the control group.The scored patient-generated subjective global assessment(PG-SGA)score,the nutritional indicator levels[serum prealbumin(PA),transferrin(TRF)],the cancer-related fatigue status[Piper fatigue scale(PFS)],the quality of life[the functional living index-cancer(FLIC)],and the incidence of adverse events were compared between the two groups before and after the intervention.Results:After the intervention,the serum TRF,PA levels and the scores of good psychology,good body and ability,and good society dimensions in the observation group were higher than those in the control group,and the scores of difficulty and nausea caused by cancer,PG-SGA,PFS scores and the incidence of adverse events were lower than those in the control group,and the differences were statistically significant(P<0.05).Conclusions:The“H2H”nutrition management model for the patients with esophageal cancer undergoing radiotherapy can improve the nutritional status,reduce the degree of cancer-related fatigue and the incidence of adverse events,and improve the quality of life.