食管癌术后居家病人营养现状及影响因素分析

Analysis of nutritional status and influencing factors in esophageal cancer patients for home-based care after surgery

目的:探究食管癌术后居家病人营养现状并分析其影响因素。方法:选取2022年7月至2023年10月就诊于东部战区总医院心胸外科并行手术治疗的153例食管癌病人,使用PG-SGA量表评估术后1月居家病人的营养状况,并分析其营养状况的影响因素。结果:本研究纳入的153例病人中,营养良好病人47例,营养不良病人106例,其中可疑或中度营养不良病人71例,重度营养不良病人35例,总体营养不良发生率为69.3%。二元Logistic回归分析结果显示,血红蛋白、白蛋白水平、营养途径、营养影响症状(NIS)、口服营养补充剂(ONS)及营养行为是病人营养状况的独立影响因素(P <0.05)。其中,NIS≥2个是病人发生营养不良的危险因素;血红蛋白、白蛋白水平正常、管饲营养、使用ONS、营养行为达标是避免营养不良发生的保护因素。结论:食管癌术后居家病人营养不良发生率较高,导致营养不良的因素较多,临床应针对相关因素采取措施并进行早期干预。

Objective:To evaluate the nutritional status and its influencing factors in esophageal cancer patients for home-based care after surgery.Methods:A total of 153 patients with esophageal cancer who underwent surgery between July 2022 and October 2023 in the General Hospital of Eastern Theater Command were enrolled in this study.The nutritional status of the patients at home in 1-month post-surgery was evaluated according to the patient-generated subjective global assessment(PG-SGA),and the possible influencing factors were analyzed.Results:Among the 153 patients,47 were well-nourished and 106 were malnourished,with an overall malnutrition rate of 69.3%.For the malnutritional patients,71 were suspected or moderately malnourished and 35 were severely malnourished.The hemoglobin levels,serum albumin levels,the route for nutrition support delivery,nutrition impact symptoms(NIS),oral nutritional supplements(ONS)and nutritional behavior were independent influencing factors of nutritional status(P<0.05),in which NIS≥2 was a risk factor for malnutrition in the patients.Normal hemoglobin and albumin levels,enteral tube feeding,oral nutritional supplement and achieving standard of nutritional behavior were protective factors for avoiding the presence of malnutrition.Conclusion:The esophageal cancer patients for home-based care after surgery have a high incidence of malnutrition.Many factors,including nutrient delivery route and nutritional behavior,were related to the occurrence of in the patients.Certain measures to the related factors should be taken early for preventing malnutrition in clinical practice.