[1]周 凯,苟小霞,马 虎,等.鼻咽癌住院病人营养状况分析及对生活质量的影响[J].肠外与肠内营养杂志,2024,(05):280-287.[doi:DOI : 10.16151/j.1007-810x.2024.05.005]
　ZHOU Kai,GOU Xiao-xia,MA Hu,et al.Analysis of nutritional status of nasopharyngeal carcinoma patients andits impact on quality of life[J].PARENTERAL & ENTERAL NUTRITION,2024,(05):280-287.[doi:DOI : 10.16151/j.1007-810x.2024.05.005]
点击复制

鼻咽癌住院病人营养状况分析及对生活质量的影响()
分享到：

《肠外与肠内营养》杂志[ISSN:1007-810X/CN:32-1477/R]

卷:
期数:
2024年05期
页码:
280-287
栏目:
论著
出版日期:
2024-10-10

文章信息/Info

Title:
Analysis of nutritional status of nasopharyngeal carcinoma patients andits impact on quality of life
作者:
周 凯; 苟小霞; 马 虎; 何国平; 田 昕; 徐 晖; 冯 碧
遵义医科大学第二附属医院肿瘤科，贵州遵义 563000
Author(s):
ZHOU Kai;  GOU Xiao-xia;  MA Hu;  HE Guo-ping;  TIAN Xin;  XU Hui;  FENG Bi
Department of Oncology, The Second Affiliated Hospital of Zunyi Medical University, Zunyi 563000,Guizhou,China
关键词:
鼻咽癌 ; 营养状况 ; PG-SGA ; 生活质量 ; 营养不良
Keywords:
Nasopharyngeal carcinoma;  Nutritional status;  PG-SGA;  Quality of life;  Malnutrition
分类号:
R739.63
DOI:
DOI : 10.16151/j.1007-810x.2024.05.005
文献标志码:
A
摘要:
目的：探讨鼻咽癌住院病人营养状况与生活质量的相关性并分析影响营养状况的因素，为临床营养支持治疗提供依据。 方法：本研究通过回顾性收集遵义医科大学附属医院头颈肿瘤科 2014 年至 2019 年符合入排标准的鼻咽癌住院病人数据；运用 NRS 2002 量表进行营养风险筛查，PG-SGA 量表进行营养状况评估，以及EORTCQLQ-C30 V3.0 量表评估生活质量。进一步探讨营养状况和生活质量之间的相关性，以及影响营养状况的因素。 结果：共收集 216 例病人，其中男性病人 168 例(77.78％) ; 平均年龄（50.50 ± 10.58）岁；26.85% 存在营养风险(NRS 2002 ≥ 3 分)；28.70% 病人中度营养不良(PG-SGA 4 ~ 8 分)，23.15% 病人重度营养不良(PG-SGA ≥ 9 分)。不同营养状况病人的多项体格检查（如体质量、体质指数、上臂中点肌肉周径等）、血液生化指标（如前白蛋白、中性粒细胞、尿素氮等）组间具有差异(P < 0.05)。重度营养不良(PG-SGA ≥ 9 分)单因素分析显示，年龄≥ 65 岁是发生重度营养不良的危险因素(OR 值：3.429，95%CI：1.467 ~ 8.014，P = 0.004)，而高学历（高中及以上）是保护因素(OR 值：0.027，95%CI：0.011 ~ 0.064，P < 0.001)。鼻咽癌病人营养状况越差，生活质量越低。 结论：鼻咽癌病人营养不良发生率高；病人营养状况越差，生活质量越低下；建议鼻咽癌病人在入院后进行常规营养诊断和治疗，以改善临床结局。
Abstract:
Objective: To investigate the correlation between nutritional status and quality of life in inpatientswith nasopharyngeal carcinoma and to analyze the factors affecting nutritional status, so as to provide evidence forclinical nutritional support treatment. Methods: In this study, we retrospectively collected data from patients withnasopharyngeal carcinoma who met the inclusion and exclusion criteria in the Head and Neck Oncology Department ofZunyi Medical University Affiliated Hospital from 2014 to 2019. The NRS 2002 scale was used for nutritional riskscreening, the PG-SGA scale for nutritional status assessment and the EORTCQLQ-C30 V3.0 scale for quality of lifeassessment. To further explore the correlation between nutritional status and quality of life, as well as the factorsaffecting nutritional status. Results: A total of 216 patients were collected, including 168 male (77.78%); average age(50.5 ± 10.58) years; 26.85% were at nutritional risk (NRS 2002 score ≥3)；28.70% were moderate malnutrition (PGSGA score 4-8), and 23.15% were severe malnutrition(PG-SGA score ≥9). There were significant differences in severalphysical examinations (such as body weight, body mass index, muscle circumference at the midpoint of the upper arm, etc.) and blood biochemical indexes (such as prealbumin, neutrophils, urea nitrogen, etc.) of patients with differentnutritional status were differed between groups (P < 0.05). Univariate analysis showed that age ≥ 65 years was a riskfactor for the development of severe malnutrition (OR: 3.429, 95% CI: 1.467 to 8.014, P = 0.004), whereas a high levelof education (senior high school and above) was a protective factor (OR: 0.027, 95% CI: 0.011 to 0.064, P = 0.000). Thepoorer the nutritional status of nasopharyngeal carcinoma patients, the lower the quality of life. Conclusion:Nasopharyngeal carcinoma patients have a high incidence of malnutrition; the poorer the nutritional status of the patient,the lower the quality of life; routine nutritional diagnosis and treatment of nasopharyngeal carcinoma patients afteradmission to the hospital is recommended to improve clinical outcomes.

参考文献/References:


[1] Sung H, Ferlay J, Siegel RL, et al. Global cancer statistics 2020:GLOBOCAN estimates of incidence and mortality worldwide for36 cancers in 185 countries[J]. CA Cancer J Clin, 2021, 71(3):209-249.
[2] Anon. Cancer incidence in five continents. Volume VIII[J]. IARCSci Publ, 2002(155): 1-781.
[3] Chen YP, Chan ATC, Le QT, et al. Nasopharyngeal carcinoma[J].Lancet, 2019, 394(10192): 64-80.
[4] Thoresen L, Fjeldstad I, Krogstad K, et al. Nutritional status ofpatients with advanced cancer: the value of using the subjectiveglobal assessment of nutritional status as a screening tool[J].Palliat Med, 2002, 16(1): 33-42.
[5] Miao JJ, Wang L，Hu CS, et al. A multicenter prospectiveobservational study of nutritional status on survivalin locallyadvanced nasopharynx cancer treated by induction chemotherapyand chemoradiotherapy[J]. J Clin Oncol, 2019, 37(15 suppl):6036.
[6] Qiu C, Yang N, Tian GL, et al. Weight loss during radiotherapyfor nasopharyngeal carcinoma: a prospective study from northernChina[J]. Nutr Cancer, 2011, 63(6): 873-879.
[7] Shen LJ, Chen C, Li BF, et al. High weight loss during radiationtreatment changes the prognosis in under-/normal weightnasopharyngeal carcinoma patients for the worse: a retrospectiveanalysis of 2433 cases[J]. PLoS One, 2013, 8(7): e68660.
[8] Zhang B, Najarali Z, Ruo LY, et al. Effect of perioperativenutritional supplementation on postoperative complicationssystematic review and meta-analysis[J]. J Gastrointest Surg,2019, 23(8): 1682-1693.
[9] Vigano AL, di Tomasso J, Kilgour RD, et al. The abridged patientgenerated subjective global assessment is a useful tool for earlydetection and characterization of cancer cachexia[J]. J Acad NutrDiet, 2014, 114(7): 1088-1098.
[10] Pressoir M, Desné S, Berchery D, et al. Prevalence, risk factorsand clinical implications of malnutrition in French comprehensivecancer centres[J]. Br J Cancer, 2010, 102(6): 966-971.
[11] von Meyenfeldt M. Cancer-associated malnutrition: anintroduction[J]. Eur J Oncol Nurs, 2005, 9(Suppl 2): S35-S38.
[12] Tchekmedyian NS, Zahyna D, Halpert C, et al. Assessment andmaintenance of nutrition in older cancer patients[J]. Oncology(Williston Park), 1992, 6(2 Suppl): 105-111.
[13] Kondrup J, Allison SP, Elia M, et al. ESPEN guidelines fornutrition screening 2002[J]. Clin Nutr, 2003, 22(4): 415-421.
[14] Kondrup J, Rasmussen HH, Hamberg O, et al. Nutritional riskscreening (NRS 2002): a new method based on an analysis ofcontrolled clinical trials[J]. Clin Nutr, 2003, 22(3): 321-336.
[15] Ottery FD. Rethinking nutritional support of the cancer patient:the new field of nutritional oncology[J]. Semin Oncol, 1994, 21(6): 770-778.
[16] Bauer J, Capra S, Ferguson M. Use of the scored patientgenerated subjective global assessment (PG-SGA) as a nutritionassessment tool in patients with cancer[J]. Eur J Clin Nutr, 2002,56(8): 779-785.
[17] 孟 琼, 万崇华, 罗家洪 . 癌症患者生活质量测定量表 EORTCQLQ-C30 的应用概况[J]. 国外医学(社会医学分册), 2004, 21(4): 147-150.
[18] Wan C, Chen M, Zhang C. Comment to the Chinese version ofthe quality of life instrument EORTC QLQ-C30[J]. J Pract Oncol,2005, 20(4): 353-355.
[19] Pan HM, Cai SJ, Ji JF, et al. The impact of nutritional status,nutritional risk, and nutritional treatment on clinical outcome of2248 hospitalized cancer patients: a multi-center, prospectivecohort study in Chinese teaching hospitals[J]. Nutr Cancer, 2013,65(1): 62-70.
[20] 赵 伟, 张华颖, 赖 浩, 等 . 营养状态与鼻咽癌患者同步放化疗预后的关系[J]. 中国癌症防治杂志, 2020, 12(4): 409-414.
[21] 黎 娜, 刘 洁, 林 欣, 等 . 鼻咽癌住院患者营养状况及与PG-SGA 评分相关性研究[J]. 肿瘤代谢与营养电子杂志, 2019,6(2): 200-205.
[22] 魏学燕, 李 莹, 胡德胜 . 鼻咽癌患者放化疗期间的营养状况及其影响因素[J]. 肿瘤防治研究, 2020, 47(7): 524-530.
[23] 石汉平, 李 薇, 齐玉梅, 等 . 营养筛查与评估[M] . 北京: 人民卫生出版社, 2014.
[24] 乔 惠, 陈佩娟, 王 丽, 等 . 医护药养一体化模式对鼻咽癌病人口服营养补充依从性及生活质量的影响[J]. 肠外与肠内营养, 2018, 25(6): 337-341.
[25] 郭尔钢, 吴 成, 胡国清 . 鼻咽癌患者病程中的营养状况[J]. 中国肿瘤临床, 2018, 45(10): 492-496.
[26] 程 婷, 卢佳美, 黄婷婷, 等 . 鼻咽癌同步放化疗病人营养不良风险预测模型的构建及验证[J]. 肠外与肠内营养, 2024, 31(2):73-82.
[27] 张燕妮, 庄秋林, 谈善军, 等 .《欧洲临床营养与代谢协会老年患者临床营养和水化实践指南》解读[J]. 中华消化外科杂志,2022, 21(6): 708-725.

相似文献/References:

[1]蒲香蓉,冯宇,刘英华,等.结肠癌病人化疗前后的能量代谢测定及人体成分分析[J].肠外与肠内营养杂志,2017,01(01):10.[doi: 10.16151/j.1007-810x.2017.01.003]
　PU Xiang rong,FENG Yu,LIU Ying hua,et al.Change of energy metabolism and body composition before and after chemotherapy in patients with colon cancer[J].PARENTERAL & ENTERAL NUTRITION,2017,01(05):10.[doi: 10.16151/j.1007-810x.2017.01.003]
[2]乔 惠,陈佩娟,王 丽,等.医护药养一体化模式对鼻咽癌病人口服营养补充依从性及生活质量的影响[J].肠外与肠内营养杂志,2018,(06):337.[doi:10.16151/j.1007-810x.2018.11.004]
　QIAO Hui,CHEN Pei-juan,WANG Li,et al.Influence of ONS compliance and quality of life ofmulti-disciplinary mode on the patients with nasopharyngeal carcinoma[J].PARENTERAL & ENTERAL NUTRITION,2018,(05):337.[doi:10.16151/j.1007-810x.2018.11.004]
[3]邓桂芳,等.术前口服营养补充对消化道恶性肿瘤病人营养状况及临床结局的影响[J].肠外与肠内营养杂志,2019,(04):208.[doi:DOI : 10.16151/j.1007-810x.2019.04.004]
　DENG Gui-fang,LI Cui-yu,WEI Yuan-huan,et al.Effect of preoperative oral nutritional supplement on nutritional status and clinical outcome for patients with digestive tract malignancies[J].PARENTERAL & ENTERAL NUTRITION,2019,(05):208.[doi:DOI : 10.16151/j.1007-810x.2019.04.004]
[4]苏翔宇,高潺潺,侍方方,等.阿片类药物治疗中重度癌痛病人的营养状况及影响因素分析[J].肠外与肠内营养杂志,2019,(05):261.[doi:DOI : 10.16151/j.1007-810x.2019.05.002]
　SU Xiang-yu,GAO Chan-chan,SHI Fang-fang,et al.Nutritional status and its related factors in opioids-treated patients with moderate to severe cancer pain[J].PARENTERAL & ENTERAL NUTRITION,2019,(05):261.[doi:DOI : 10.16151/j.1007-810x.2019.05.002]
[5]吕桂兰,周婷婷,席海玲,等.握力对腹膜透析病人营养状况的预测价值[J].肠外与肠内营养杂志,2020,(06):358.[doi:DOI : 10.16151/j.1007-810x.2020.06.009]
　L? Gui-lan,ZHOU Ting-ting,XI Hai-ling,et al.Predictive value of grip strength for nutritional status in peritoneal dialysis patients[J].PARENTERAL & ENTERAL NUTRITION,2020,(05):358.[doi:DOI : 10.16151/j.1007-810x.2020.06.009]
[6]程伟鹤,李桂云,袁 媛,等.成人胶质瘤病人术前营养状况与临床预后的相关性研究[J].肠外与肠内营养杂志,2021,(02):104.[doi:DOI : 10.16151/j.1007-810x.2021.02.009]
　CHENG Wei-he,LI Gui-yun,YUAN yuan,et al.The correlation of preoperative nutritional status and clinical prognosis in patients with glioblastoma[J].PARENTERAL & ENTERAL NUTRITION,2021,(05):104.[doi:DOI : 10.16151/j.1007-810x.2021.02.009]
[7]夏娴娴,顾海娟,陆海敏,等.术前营养支持对食管癌术后营养状态、并发症及生活质量的影响[J].肠外与肠内营养杂志,2022,(05):274.[doi:10.16151/j.1007-810x.2022.05.004]
　XIA Xian-xian,GU Hai-juan,LU Hai-min,et al.Effects of preoperative nutritional support on postoperative nutritional status, complications and quality of life for esophageal cancer[J].PARENTERAL & ENTERAL NUTRITION,2022,(05):274.[doi:10.16151/j.1007-810x.2022.05.004]
[8]韩 丹,杨 帆,赵 燕,等.不同营养状态及炎症状态对老年病人肠屏障功能影响研究[J].肠外与肠内营养杂志,2023,(02):71.[doi:10.16151/j.1007-810x.2023.02.002]
　HAN Dan,YANG Fan,ZHAO Yan,et al.Influence of nutritional status and inflammatory state on intestinal barrier function of elderly patients[J].PARENTERAL & ENTERAL NUTRITION,2023,(05):71.[doi:10.16151/j.1007-810x.2023.02.002]
[9]杨园园,蒋晓涵,龚亚博,等.营养状况在胃癌病人营养知信行与生活质量间的中介效应研究[J].肠外与肠内营养杂志,2023,(02):109.[doi:DOI : 10.16151/j.1007-810x.2023.02.009]
　YANG Yuan-yuan,JIANG Xiao-han,GONG Ya-bo,et al.Mediating role of nutritional status between nutritional knowledgeattitude-practice and quality of life in patients with gastric cancer[J].PARENTERAL & ENTERAL NUTRITION,2023,(05):109.[doi:DOI : 10.16151/j.1007-810x.2023.02.009]
[10]王 荣,沈卫民,崔 杰,等.Pierre Robin 序列征病儿术前营养状况调查及营养危险因素分析[J].肠外与肠内营养杂志,2023,(04):193.[doi:DOI : 10.16151/j.1007-810x.2023.04.001]
　WANG Rong,SHEN Wei-min,CUI Jie,et al.Investigation on nutrition status and analysis of risk factors ofmalnutrition in infants with Pierre Robin sequence[J].PARENTERAL & ENTERAL NUTRITION,2023,(05):193.[doi:DOI : 10.16151/j.1007-810x.2023.04.001]

备注/Memo

备注/Memo:
基金项目 ：贵州省抗癌协会科技计划项目(抗协科技 006［2023］)；贵州省科技计划项目 (黔科合基础- ZK [2024]一般 346)；贵州省科技计划项目（黔科合成果-LC[2024]061）；北京医卫健康公益基金（编号：YWJKJJHKYJJ-F3117D）作者简介 ：周 凯，医学硕士研究生，主要从事肿瘤治疗方面研究。E-mail：Zhou1117zhou@163.com通讯作者 ：苟小霞，E-mail：gouxx2020@163.com
更新日期/Last Update: 1900-01-01