乡村振兴背景下重庆山区某二级医院恶性肿瘤患者营养风险和营养治疗的现状调查

Investigation on nutritional risk and nutritional treatment status of malignant tumor patients in a secondary hospital in in mountainous area of Chongqing under the background of rural revitalization

目的调查分析乡村振兴背景重庆山区某二级医院恶性肿瘤患者营养风险和营养治疗现状。方法选取2021年7月至2023年7月该院收治的恶性肿瘤患者2986例作为研究对象。回顾性收集患者的一般资料、营养风险发生率、营养治疗方式和种类等临床信息,并判断临床营养治疗的合理性。结果2986例患者中存在营养风险2516例,总体营养风险发生率为84.8%;营养风险患者中进行了营养治疗732例,占29.1%(732/2516)。接受肠内营养(EN)治疗186例(EN组),占25.4%(186/732);接受肠外营养(PN)治疗403例(PN组),占55.1%(403/732);接受肠内外营养联合治疗143例(联合治疗组),占19.5%(143/732)。中青年患者营养风险与营养不足发生率[分别为80.75%(910/1127)、39.57%(446/1127)]均明显低于老年患者[分别为87.24%(1606/1841)、57.41%(1057/1841)],差异均有统计学意义(P<0.05);732例患者经营养治疗后营养指标(包括身体质量指数,血清总蛋白、血红蛋白、血浆清蛋白水平)均明显优于治疗前,且联合治疗组患者经营养治疗后各营养指标均明显优于EN组、PN组,EN组患者经营养治疗后各营养指标明显优于PN组,差异均有统计学意义(P<0.05)。结论重庆山区某二级医院恶性肿瘤患者营养风险较高,营养不良发生的情况较多,且营养治疗的现状不容乐观。

Objective To investigate and analyze the nutritional risk and nutritional treatment status of malignant tumor patients in a secondary hospital in Chongqing mountainous area under the background of rural revitalization.Methods A total of 2986 malignant tumor patients admitted to the hospital from July 2021 to July 2023 were selected as the study subjects.The clinical information such as general data,incidence of nutritional risk,types and methods of nutritional therapy were collected retrospectively,and the rationality of clinical nutritional treatment was judged.Results Among the 2986 patients,2516 cases were identified with nutritional risk,resulting in an overall incidence rate of 84.8%.Among those at nutritional risk,732 patients received nutritional therapy,accounting for 29.1%(732/2516).Specifically,186 patients received enteral nutrition(EN)therapy(the EN group,25.4%of 732),403 received parenteral nutrition(PN)therapy(the PN group,55.1%of 732),and 143 received combined enteral and parenteral nutrition(the combined therapy group,19.5%of 732).The incidence rates of nutritional risk and malnutrition were significantly lower in middle-aged and young patients[80.75%(910/1127)and 39.57%(446/1127)respectively]compared to elderly patients[87.24%(1606/1841)and 57.41%(1057/1841)respectively],with all differences being statistically significant(P<0.05).After nutritional therapy,nutritional indicators including body mass index,serum total protein,hemoglobin,and plasma albumin levels significantly improved in the 732 treated patients.Patients in the combined therapy group showed better outcomes in all nutritional indicators compared to those in the EN and PN groups,and the EN group showed better outcomes compared to the PN group,with all differences being statistically significant(P<0.05).Conclusion The nutritional risk of malignant tumor patients in a secondary hospital in Chongqing mountainous area is high,the incidence of malnutrition is high,and the status of nutritional treatment is not optimistic.