基于营养风险筛查应用不同方式营养干预对胃肠肿瘤患者的效果研究
Effect of Different Nutritional Interventions Based on Nutritional Risk Screening on Patients with Gastrointestinal Cancer
屈甜甜 1刘源 1周玉凯 1王聪1
作者信息
- 1. 南阳市第二人民医院,河南 南阳 473000
- 折叠
摘要
目的:基于营养风险筛查 2002(NRS2002)筛查结果探讨晚期胃肠道肿瘤患者接受不同方式营养干预的可行性及有效性.方法:选取南阳市第二人民医院肿瘤科2022 年 6 月至2023 年 5 月收治的228 例胃肠道肿瘤晚期(不可手术切除)患者为研究对象,由经过营养科培训的护士每日应用NRS2002进行营养风险筛查,确定存在营养风险.按照临床医生治疗情况及患者意愿决定营养支持方式,将有营养风险的胃肠道肿瘤患者分成对照组(单瓶肠外营养治疗)、观察组A("全合一"肠外营养治疗)、观察组B(肠内营养治疗),评估不同营养支持方式患者的焦虑、抑郁、生活质量评分、不良反应发生情况和治疗前后营养相关的化验指标的变化.结果:干预后,观察组A和观察组B两组患者的焦虑自我评价量表(SAS)、抑郁自我评价量表(SDS)、健康相关生命质量评分量表(HRQOL)评分均低于对照组,差异具有统计学意义(P＜0.05);观察组B患者便秘和腹胀的情况高于对照组,感染情况低于对照组与观察组A,差异具有统计学意义(P＜0.05);干预后观察组A和观察组B两组患者的血清转铁蛋白(TRF)、白蛋白(ALB)、前白蛋白(PA)水平显著高于对照组,差异具有统计学意义(P＜0.05).结论:营养支持治疗在改善患者营养指标方面有着积极的意义,尤其是采用肠内营养和"全合一"肠外营养治疗方式的患者.但无论何种营养支持方式均不能极大地改变患者疾病的发展整体形势.
Abstract
Objective Based on the results of Nutritional Risk Screening 2002(NRS2002),the feasibility and effectiveness of different nutritional interventions in patients with advanced gastrointestinal tumors were investigated.Methods A total of 228 patients with advanced gastrointestinal tumors(inoperable)admitted to the Oncology Department of Nanyang Second People's Hospital from June 2022 to May 2023 were selected as the study objects.Nurses trained in the nutrition department applied NRS2002 daily for nutritional risk screening to determine the presence of nutritional risk.According to the treatment conditions of clinicians and patients'wishes,nutritional support methods were determined.Patients with gastrointestinal tumors with nutritional risks were divided into control group(single bottle parenteral nutrition treatment),observation group A("all-in-one"parenteral nutrition treatment)and observation group B(enteral nutrition treatment).The changes of anxiety,depression,quality of life scores,adverse reactions and nutrition-related laboratory indicators before and after treatment were evaluated in patients with different nutritional support methods.Results After intervention,the scores of self-rating anxiety scale(SAS),self-rating depression scale(SDS)and health-related quality of life(HRQOL)in Observation Group A and Observation Group B were lower than those in control group,with statistical significance(P<0.05).The constipation and abdominal distension of observation group B was higher than that of control group,and the infection was lower than that of control group and observation group A,the difference was statistically significant(P<0.05).After intervention,the levels of serum transferrin(TRF),albumin(ALB)and prealbumin(PA)in observation groups A and B were significantly higher than those in control group,with statistical significance(P<0.05).Conclusion Nutritional support therapy has a positive significance in improving the nutritional indexes of patients,especially in patients who adopt enteral nutrition and"all-in-one"parenteral nutrition therapy.However,no matter what kind of nutritional support can not greatly change the overall situation of disease development of patients.
关键词
胃肠道肿瘤/营养风险筛查2002/肠外营养/肠内营养Key words
Gastrointestinal tumor/Nutritional risk screening 2002/Parenteral nutrition/Enteral nutrition引用本文复制引用
出版年
2024
NETL
NSTL
万方数据