直肠癌患者放化疗期间营养状况调查分析

A Survey on the Nutrition Situation of Rectal Cancer Patients at Radio-chemotherapy Duration

为分析直肠癌患者放化疗期间的营养状况及其变化规律,选择2017年1月至2018年6月于我科接受放疗的90例直肠癌患者作为研究对象,患者均同时接受化疗,且未接受手术治疗。分别于放疗前(T0)及放疗第1~5周每周结束时(T1~T5),应用营养风险筛查量表(NRS2002)和患者主观整体评估表(PG-SGA)对患者营养状况进行评估。结果显示,随着治疗时间的延长,患者体质量逐渐降低,除T0-1、T2-3差异无统计学意义(P>0.05)外,T1-2、T3-4、T4-5差异均有统计学意义,P<0.05。放疗前即有34.4%患者存在营养风险(NRS2002评分≥3分),放疗期间35.6%~57.8%存在营养风险。中度营养不良占17.8%~33.3%,重度营养不良占0~34.4%。体质量下降≥5%者治疗不耐受发生率(85.7%,18/21)明显高于体质量下降<5%者(46.9%,23/49),P <0.05。结果表明,直肠癌患者存在营养风险,放化疗会增加其营养风险,随着治疗时间的延长,营养风险逐渐增加。体质量明显下降者治疗耐受性较差。临床工作中,应积极改善患者营养状况,提高患者放化疗耐受性,保证治疗的顺利实施。

In order to analyse the nutrition situation of rectal cancer patients at radio-chemotherapy duration and seek its change regularity,authors enrolled 90 rectal cancer patients treated with above therapy in author’s department(2017-01-2018-06)into this study,which the patients received chemotherapy,not surgery at the same time;then received nutrition situation evaluation by using NRS2002 and PG-SGA at T0(i.e before radiotherapy)and at T1-T5(i.e at the end of No.1 to No.5 week of radiotherapy).As results,along with therapy time lengthening,patients’body mass gradually decreased,in that at T0-1,T2-3 there was no statistical difference(P<0.05),but at T1-2,T3-4,T4-5 there were all statistical difference(P<0.05),before radiotherapy,34.4%of patients just had nutrition risk(their NRS 2002 rating≥3 points),and at duration of radiotherapy,up to 35.6%-57.8%of patients;mid-inanition up to 17.8%-33.3%,severe inanition up to 0-34.4%;the intolerance rate to therapy in who’s body mass was declined up to≥5%was significantly higher than in who’s body mass were<5%[85.7%(18/21)vs 46.9%(23/49),P<0.05].Results show that rectal cancer patients have nutrition risk,but radio-chemotherapy again increase this risk;And along with therapy time lengthening,this risk gradually increase,patients’body mass obvious decrease,so that their tolerance becoming more poor;therefore,clinically it should be actively improving patients’nutrition situation,enhancing their tolerance to radio-chemotherapy,for ensuring therapy smooth.