营养干预及集束护理对中晚期胃癌患者化疗期间营养状况和生活质量的影响

Effect of nutritional intervention and care bundle on nutritional status and quality of life of the advanced gastric cancer patients undergoing chemotherapy

目的探讨营养干预及集束护理对中晚期胃癌患者化疗期间营养状况和生活质量的影响。方法将81例中晚期胃癌化疗患者随机分为观察组41例和对照组40例。观察组在常规化疗和辅助治疗的基础上,接受营养干预及集束护理;对照组进行常规治疗和护理。治疗前后分别对两组进行体质量、营养指数(PNI)、生活质量及生活质量症状维度进行评价。采用SPSS 16.0统计软件进行分析;计量资料用均数±标准差(xˉ±s)表示,采用t检验,计数资料用率(%)表示,采用χ2检验,P<0.05表示差异有统计学意义。结果两组患者在第6次化疗结束后体质量均有所下降,但观察组体质量下降百分比显著低于对照组[(6.80%±0.96)%比(11.10%±1.34)%]。两组患者第1次化疗前PNI差异无统计学意义(P>0.05),而第6次化疗后观察组PNI显著高于对照组(P=0.004 0)。与第1次化疗前比较,两组化疗结束后PNI均下降,但观察组差异无统计学意义(P>0.05),对照组化疗后PNI显著低于化疗前(P=0.000 0)。干预后观察组在整体生活质量及5个功能维度方面均有不同程度的改善,干预后两组的整体生活质量、躯体功能和角色功能方面差异有统计学意义(P<0.05)。两组生活质量症状维度的评分比较:干预后观察组在症状维度方面疲乏、疼痛方面差异有统计学意义(P<0.01)。结论通过对中晚期胃癌化疗患者进行营养干预及集束护理,改善了患者的营养状况,提高了生活质量。

Objective To observe the effect of nutritional intervention and care bundle on the nutritional status and quality of life of the advanced gastric cancer patients undergoing chemotherapy. Methods A total of 81 advanced gastric cancer patients undergoing chemotherapy were randomly divided into the experimental group(n=41) and control group(n=40). The experimental group not only received conventional chemotherapy and adjunctive therapy but also nutritional interventional and care bundle. The control group only received conventional chemotherapy, adjunctive therapy and regular care. Body weight,prognostic nutritional index(PNI) and quality of life of the two groups were evaluated before and after treatment. Results After the 6th chemotherapy, patients' body weight in both groups was decreased.However, the percentage weight loss of the experimental group was significantly lower than that of the control group(6.8% ± 0.96% vs 11.1% ± 1.34%, P=0.000 0). There was no significant difference between the two groups for PNI before the 1st chemotherapy. However, there was significant difference after the 6th chemotherapy, and the PNI of observation group was much higher than that of the control group(P=0.000 0). Compared with the PNI before first chemotherapy, the PNI of both groups after chemotherapy was decreased. The difference of PNI of the control group before and after chemotherapy was statisticaly significant(P=0.000 0), while that of the observation group was not statistical significant. The whole quality of life and the five functional dimensions of the experimental group were improved at various degrees after intervention, which were significantly different from those of the control group(P<0.01). Conclusion Through nutritional intervention and care bundle in patients undergoing advanced gastric cancer chemotherapy, the nutritional status and the quality of life are significantly improved.