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住院恶性胃部肿瘤患者营养状况调查分析及其对生活质量的影响。

Survey and analysis of the nutritional status in hospitalized patients with malignant gastric tumors and its influence on the quality of life.

机构信息

Department of Medical Oncology, Fujian Cancer Hospital, Fujian Medical University Cancer Hospital, Fuzhou, 350014, Fujian, China.

Cancer Center of the First Hospital of Jilin University, Changchun, 130021, Jilin, China.

出版信息

Support Care Cancer. 2020 Jan;28(1):373-380. doi: 10.1007/s00520-019-04803-3. Epub 2019 May 3.

Abstract

BACKGROUND/OBJECTIVES: The assessment of nutritional status and the quality of life in patients with gastric cancer has become one of the important goals of current clinical treatment. The purpose of this study was to assess the nutritional status in hospitalized gastric cancer patients by using patient-generated subjective global assessment (PG-SGA) and to analyze the influence of nutritional status on the patients' quality of life (QOL).

METHODS

We reviewed the pathological diagnosis of gastric cancer for 2322 hospitalized patients using PG-SGA to assess their nutritional status and collected data on clinical symptoms, the anthropometric parameters (height, weight, body mass index (BMI), mid-arm circumference (MAC), triceps skin-fold thickness (TSF), and hand-grip strength (HGS). We also collected laboratory data (prealbumin, albumin, hemoglobin) within 48 h after the patient was admitted to the hospital. The 30-item European Organization for Research and Treatment of Cancer Core Quality of Life Questionnaire (EORTC QLQ-C30) was used for QOL assessment in all patients.

RESULTS

By using PG-SGA, we found 80.4% of the patients were malnourished (score ≥ 4) and 45.1% of the patients required urgent nutritional support (score ≥ 9). In univariate analysis, old age (> 65 years, p < 0.001), female (p = 0.007), residence in a village (p = 0.004), a lower level of education (p < 0.001), and self-paying (p < 0.001) were indicated as risk factors of patients with gastric cancer to be suffering from severe malnutrition. There was a negative correlation between PG-SGA and various nutritional parameters (p < 0.05). The quality of life was significantly different in gastric cancer patients with different nutritional status (p < 0.01).

CONCLUSION

Malnutrition of hospitalized patients with gastric cancer in China is common and seriously affects the patients' quality of life. The nutritional status should be evaluated in a timely manner and reasonable nutritional intervention should be provided as soon as possible. The PG-SGA was fit for using as a clinical nutrition assessment method, being worthy of clinical application.

摘要

背景/目的:评估胃癌患者的营养状况和生活质量已成为当前临床治疗的重要目标之一。本研究旨在使用患者自评主观全面评估(PG-SGA)评估住院胃癌患者的营养状况,并分析营养状况对患者生活质量(QOL)的影响。

方法

我们回顾性分析了 2322 例住院胃癌患者的病理诊断,使用 PG-SGA 评估其营养状况,并收集了临床症状、人体测量参数(身高、体重、体重指数(BMI)、上臂中部周长(MAC)、三头肌皮褶厚度(TSF)和手握力(HGS)的数据。我们还收集了患者入院后 48 小时内的实验室数据(前白蛋白、白蛋白、血红蛋白)。所有患者均采用欧洲癌症研究与治疗组织核心生活质量问卷(EORTC QLQ-C30)进行 QOL 评估。

结果

使用 PG-SGA,我们发现 80.4%的患者存在营养不良(评分≥4),45.1%的患者需要紧急营养支持(评分≥9)。单因素分析显示,年龄较大(>65 岁,p<0.001)、女性(p=0.007)、居住在农村(p=0.004)、教育程度较低(p<0.001)和自费(p<0.001)是胃癌患者发生严重营养不良的危险因素。PG-SGA 与各种营养参数呈负相关(p<0.05)。不同营养状况的胃癌患者生活质量有显著差异(p<0.01)。

结论

中国住院胃癌患者营养不良较为常见,严重影响患者生活质量。应及时评估营养状况,并尽快提供合理的营养干预。PG-SGA 适合作为临床营养评估方法,值得临床应用。

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