de Graeff Alexander, Vogel Jeanne, Jager-Wittenaar Harriët, Chua-Hendriks Jolanda J C, Beijer Sandra
UMC Utrecht, afd. Medische Oncologie, Utrecht, the Netherlands.
Ned Tijdschr Geneeskd. 2012;156(38):A4911.
Malnutrition is a condition characterized by a shortage or imbalance of energy and proteins and/or other nutrients. Malnutrition leads to measurable undesirable effects on body size and composition, functioning and clinical results. Criteria for malnutrition are eight loss, low BMI and loss of muscle mass. Patients with cancer should be repeatedly screened for malnutrition and its risk factors during the diagnostic and therapeutic treatment trajectory. Patients with cancer who are malnourished or are at risk of becoming so should be referred to a dietician for individualized dietary advice if they are undergoing curative treatment or before they do so. At the start of radiotherapy and/or chemotherapy treatment, tube feeding or parenteral feeding is given to all cancer patients who are malnourished or are at high risk of becoming malnourished. If the gastrointestinal tract is functioning well then tube feeding is preferable to parenteral feeding. Patients who are at an advanced stage of cancer and cancer patients who are anorexic or lose weight can be treated with megastrol acetate.
营养不良是一种以能量、蛋白质和/或其他营养素短缺或失衡为特征的状况。营养不良会对身体大小、组成、功能和临床结果产生可测量的不良影响。营养不良的标准包括体重减轻、低体重指数和肌肉量减少。在癌症诊断和治疗过程中，应对癌症患者反复进行营养不良及其风险因素的筛查。对于正在接受根治性治疗或即将接受根治性治疗的营养不良或有营养不良风险的癌症患者，应转介给营养师以获取个性化饮食建议。在放疗和/或化疗开始时，应给予所有营养不良或有高营养不良风险的癌症患者管饲或肠外营养支持。如果胃肠道功能良好，管饲优于肠外营养支持。处于癌症晚期的患者以及厌食或体重减轻的癌症患者可用醋酸甲地孕酮治疗。
