优化营养管理在儿童成熟B细胞淋巴瘤中应用的效果观察

A study of optimal nutrition management in children with B-cell non-Hodgkin lymphoma

目的探讨全程营养管理在儿童成熟B细胞淋巴瘤中应用的效果。方法回顾性研究,采用历史对照设计。研究对象为北京儿童医院儿童肿瘤中心肿瘤内科初诊并完成治疗的127例成熟B细胞淋巴瘤患儿,分为2组,2020年7月—2021年7月治疗的63例为对照组,给予常规护理模式;2021年8月—2022年8月治疗的64例为管理组。收集两组患儿住院期间的基本临床资料、主要并发症及体重波动、血红蛋白、白蛋白、淋巴细胞绝对值等营养相关指标,并给予管理组全程营养管理。结果化疗结束后管理组和对照组BMI[(17.1±2.8)kg/m^(2)比(16.0±2.8)kg/m^(2)]、营养不良评分[(0.2±1.1)比(-0.3±1.4)]、白蛋白[(43.7±3.5)g/L比(40.9±3.9)g/L]、前白蛋白[(208.9±59.8)mg/L比(188.9±43.5)mg/L]及淋巴细胞绝对值[(1.1±0.6)×10^(9)/L比(0.9±0.4)×10^(9)/L]均优于对照组,差异有统计学意义(P<0.05);肺炎(23.4%比39.7%)、败血症(14.1%比31.7%)、其它感染(15.6%比33.3%)发生率均低于对照组,差异有统计学意义(P<0.05),其它并发症发生率均无统计学意义(P>0.05);转入ICU(4.7%比15.9%)、非化疗入院(32.8%比50.8%)和营养不良(11.1%比25.0%)比例均低于对照组,差异有统计学意义(P<0.05)。结论优化营养管理,可改善患儿营养状况和预后,避免营养相关不良事件发生。

Objective To investigate the efficacy of whole-course nutrition management in children with B-cell non-Hodgkin lymphoma.Methods A retrospective study was conducted using a historical control design.The subjects were 127 children with B-cell non-Hodgkin lymphoma who were newly diagnosed and completed treatment in the Department of Oncology,Children′s Cancer Center,Beijing Children′s Hospital,divided into 2 groups.From July 2020 to July 2021,63 patients were treated as control group and received routine nursing mode;The 64 patients treated from August 2021 to August 2022 were in the management group.Basic clinical data,major complications,weight fluctuation,hemoglobin,albumin,absolute value of lymphocytes and other nutrition-related indexes of the two groups were collected during hospitalization,and the management group was given whole-course nutrition management.Results Chemotherapy management group and the control group after the BMI than[(17.1t group.B^(2) vs.16.0therapy^(2))],malnutrition score[0.2up and vs.0.3 nutrition score][0.2up and the vs.40.9nutrition scprealbumin][(208.9umin)mg/L vs.(188.9umin)mg/L]and the lymphocyte absolute value[1.1roup×10^(9)/L vs.(0.9/L)a×10^(9)/L]were superior to control group,the difference was statistically significant(P<0.05).The incidence of pneumonia(23.4%vs.39.7%),sepsis(14.1%vs.31.7%),and other infections(15.6%vs.33.3%)were lower than those in the control group,with statistically significant(P<0.05),and the incidence of other complications was not statistically significant(P>0.05);The proportion of ICU transfer(4.7%vs.15.9%),non chemotherapy admission(32.8%vs.50.8%)and malnutrition(11.1%vs.25.0%)were lower than those in the control group,with significant difference(P<0.05).Conclusions Optimization of nutrition management can improve the nutritional status and prognosis of children and avoid the occurrence of nutrition-related adverse events.