妇科恶性肿瘤化疗患者营养状况降低的影响因素

Influencing Factors of Reduced Nutritional Status in Patients with Gynecological Malignant Tumor Undergoing Chemotherapy

目的调查妇科恶性肿瘤化疗患者营养状况降低情况,探究其影响因素。方法选取2023年3月至2023年7月新乡市中心医院(新乡医学院第四临床学院)的247例妇科恶性肿瘤化疗患者,收集患者临床资料,调查其营养状况,以患者完成主观整体评估问卷(PG-SGA)评估患者营养状态,将评分≥2分患者定义为营养降低,纳入降低组,反之为营养未降低,纳入未降低组。对比两组临床资料,采用lasso筛选出与患者营养状况降低相关的指标,进入logistic多因素回归分析妇科恶性肿瘤化疗患者营养状况降低的影响因素。结果247例接受患者化疗的妇科恶性肿瘤患者营养状况降低发生率为30.36%(75/247),可疑营养不良、中度营养不良、重度营养不良占比分别为21.33%(16/75)、54.67%(41/75)、24.00%(18/75)。经lasso回归分析筛选,获得6个预测因素,且logistic多因素分析显示,TNM分期、经济水平、前1周饮食状况、味觉改变、抑郁、血清白蛋白是妇科恶性肿瘤化疗患者营养状况降低的影响因素(P<0.05)。结论妇科恶性肿瘤化疗患者营养状况降低受抑郁、TNM分期、味觉改变等多因素影响,医护工作者可据此实施针对性护理以改善患者营养状况。

Objective To investigate the reduction of nutritional status in patients with gynecological malignant tumor undergoing chemotherapy and explore its influencing factors.Methods A total of 247 patients with gynecological malignant tumor undergoing chemotherapy in Xinxiang Central Hospital(the Fourth Clinical College of Xinxiang Medical College)from March 2023 to July 2023 were selected,clinical data of the patients were collected,their nutritional status was investigated,and the nutritional status of the patients was assessed by patient-generated subjective global assessment(PG-SGA).Patients with scores≥2 were defined as nutrient-impaired and included in the reduced group,whereas those with no nutritional impaired were included in the non-reduced group.By comparing the clinical data of the two groups,lasso was used to screen out the indicators related to the reduction of nutritional status of patients,and logistic multifactor regression was applied to analyze the influencing factors of the reduction of nutritional status of patients with gynecological malignant tumor undergoing chemotherapy.Results In 247 patients with gynecological malignancies treated with chemotherapy,the incidence of decreased nutritional status was 30.36%(75/247),and the rates of suspicious malnutrition,moderate malnutrition and severe malnutrition were 21.33%(16/75),54.67%(41/75)and 24.00%(18/75),respectively.Six predictors were selected by lasso regression analysis,and logistic multivariate analysis showed that TNM stage,economic level,diet status in the previous week,taste change,depression,serum albumin was the influence factor of reduced nutritional status in patients with gynecological malignant tumor undergoing chemotherapy(P<0.05).Conclusion The reduction of nutritional status of patients with gynecological malignant tumor undergoing chemotherapy is affected by depression,TNM stage,taste change and other factors,so medical workers can implement targeted nursing to improve the nutritional status of patients.