鼻咽癌放射治疗患者营养不良现状及危险因素分析

Current status and risk factors for malnutrition in nasopharygeal carcinoma patients undergoing radiotherapy:an analytic study

目的 了解鼻咽癌放射治疗(放疗)患者营养不良的现状,并分析其危险因素。方法 采取便利抽样法,选取南宁市某三级甲等医院放疗科281例鼻咽癌放疗患者作为研究对象,分析患者的营养不良现状。在放疗结束前1 d指导患者进行人体成分分析检测,采用问卷调查表调查患者的一般资料,并收集患者的血生化指标、放化疗不良反应、运动锻炼情况、焦虑、抑郁等资料。采用多因素Logistic回归模型分析鼻咽癌放疗患者营养不良的危险因素。结果 281例鼻咽癌放疗患者营养不良的发生率为48.75%(137/281)。多因素Logistic回归分析结果显示,不规律运动锻炼、低骨骼肌质量指数、咽损伤程度重、焦虑是鼻咽癌放疗患者发生营养不良的危险因素(P<0.05)。结论 鼻咽癌放疗患者营养不良的发生率较高,临床医护人员应早期识别营养不良的高危人群,针对不同特征患者进行个体化干预,改善患者营养不良现状,降低营养不良的发生率。

Objective To understand the current status of malnutrition in nasopharyngeal carcinoma patients undergoing radiotherapy,and to analyze its risk factors.Methods A total of 281 nasopharyngeal carcinoma patients undergoing radiotherapy in the Radiotherapy Department of a classⅢlevel A hospital in Nanning were selected as research subjects by employing the convenience sampling method.The current status of malnutrition was analyzed in patients.Patients were instructed to perform body composition analysis and detection 1 day before the end of radiotherapy,and general data of patients were investigated by using the questionnaire investigation,and data such as blood biochemical indices,adverse reactions to chemoradiotherapy,exercise states,anxiety,and depression were collected.The risk factors for malnutrition in nasopharyngeal carcinoma patients undergoing radiotherapy were analyzed by employing the multivariate Logistic regression model.Results The incidence rate of malnutrition was 48.75%(137/281)among 281 nasopharyngeal carcinoma patients undergoing radiotherapy.The results of multivariate Logistic regression analysis revealed that irregular exercise,low skeletal muscle mass index,severe pharyngeal injury,and anxiety were the risk factors for the occurrence of malnutrition in nasopharyngeal carcinoma patients undergoing radiotherapy(P<0.05).Conclusion The incidence rate of malnutrition in nasopharyngeal carcinoma patients undergoing radiotherapy is relatively high.Clinical medical and nursing personnel should early identify high‐risk population of malnutrition,and perform individualized intervention for patients with different characteristics to improve current status of malnutrition in patients,and to decrease the incidence rate of malnutrition.