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一项多中心研究旨在实施营养风险筛查,并评估癌症患者的临床结局和生活质量。

A multicentre study to implement nutritional risk screening and evaluate clinical outcome and quality of life in patients with cancer.

机构信息

Department of Clinical Nutrition, Chinese Academy of Medical Sciences, Beijing, China.

出版信息

Eur J Clin Nutr. 2013 Jul;67(7):732-7. doi: 10.1038/ejcn.2013.81. Epub 2013 Apr 17.

Abstract

BACKGROUND/OBJECTIVES: To implement nutritional risk screening and evaluate the relationship of nutritional risk to complication rate and quality of life in patients with cancer.

SUBJECTS/METHODS: A total of 687 patients with cancer from two teaching hospitals in China were consecutively enrolled. Data were collected on the nutritional risk screening, application of nutritional support, complication and quality of life.

RESULTS

The prevalence of nutritional risk at admission among the total, younger and elderly patients was 45.6%, 38.7% and 58.0%, respectively. There was a significant increase in the prevalence from admission to 2 weeks after admission in all patients (P=0.011). The prevalence in those patients ≥70 years was significantly higher than that in the younger ones (P<0.001). The highest prevalence of nutritional risk was in pancreas cancer (81.8%). Only 46.7% of at-risk patients received nutritional support and the average PN:EN ratio was 7.0:1. Complications were noted in 29.0% of all patients and were significantly more frequent in 'at-risk' patients (P<0.001). Among the scales of quality of life (SF-36), the scores of physical functioning (P<0.001), role-physical (P<0.001), bodily pain (P=0.012), energy/fatigue (P<0.001) and general health (P<0.001) were significant lower in the patients at risk.

CONCLUSIONS

A large proportion of cancer inpatients were at nutritional risk and tended to worsen during the course of admission, which has been associated with increased complication rate and lower scores of quality of life. The application of PN and EN was inappropriate in patients with cancer in China.

摘要

背景/目的:对癌症患者进行营养风险筛查,并评估营养风险与并发症发生率和生活质量的关系。

对象/方法:连续纳入中国两家教学医院的 687 例癌症患者。收集营养风险筛查、营养支持应用、并发症和生活质量的数据。

结果

总患者、年轻患者和老年患者入院时营养风险的发生率分别为 45.6%、38.7%和 58.0%。所有患者从入院到入院后 2 周,营养风险的发生率显著增加(P=0.011)。≥70 岁患者的发生率明显高于年轻患者(P<0.001)。营养风险发生率最高的是胰腺癌(81.8%)。仅有 46.7%的高危患者接受了营养支持,肠外营养与肠内营养的平均比例为 7.0:1。所有患者中有 29.0%出现并发症,高危患者的并发症发生率明显更高(P<0.001)。在生活质量量表(SF-36)中,身体功能(P<0.001)、生理职能(P<0.001)、躯体疼痛(P=0.012)、精力/疲劳(P<0.001)和一般健康(P<0.001)的评分在有风险的患者中显著较低。

结论

相当一部分住院癌症患者存在营养风险,且在住院期间有恶化趋势,这与并发症发生率增加和生活质量评分降低有关。中国癌症患者的 PN 和 EN 应用不当。

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