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目的调查胃癌患者首次化疗前营养风险及营养支持干预效果。方法通过营养风险筛查2002(NRS2002)对2014年1月-2016年10月接受首次化疗干预的160例胃癌患者进行营养风险评估,并比较分析营养支持干预与患者治疗前后营养相关指标、化疗毒副反应及并发症情况。结果 160例胃癌患者经营养风险评估,存在营养风险(NRS评分≥3分)率53.75%(86例)。无营养风险(NRS评分<3分)46.25%(74例)。年龄≥50岁患者营养风险率高于<50岁患者,差异有统计学意义(χ~2=7.689,P<0.05),而不同BMI患者营养风险率比较差异无统计学意义(χ~2=5.365,P>0.05);86例有营养风险患者中66例接受营养支持干预(营养支持组),20例没有接受营养支持干预(无营养支持组)。在首次化疗前,无营养风险(对照组)、营养支持组、无营养支持组三组ALB、HB、PA水平差异无统计学意义(均P>0.05);在首次化疗1个周期结束后无营养风险(对照组)、营养支持组患者化疗后血清ALB、HB、PA水平均显著高于无营养支持组(均P<0.05),而对照组、营养支持组化疗后血清ALB、HB、PA水平差异无统计学意义(均P>0.05);营养支持组和无营养支持组两组化疗毒副反应发生率比较差异无统计学意义(P>0.05);营养支持组贫血发生率显著低于无营养支持组(P=0.024)。结论胃癌患者营养风险比例大,对此给予营养支持干预能明显改善患者营养状况,降低贫血发生率。
Objective To investigate the nutritional risk and the effect of nutritional support before the first chemotherapy in gastric cancer patients. Methods Nutritional risk screening 2002 (NRS2002) evaluated the nutritional risk of 160 patients with gastric cancer who underwent first-episode chemotherapy from January 2014 to October 2016. Nutritional support interventions were compared with those of patients before and after treatment Side effects and complications. Results 160 cases of gastric cancer patients with nutritional risk assessment, there is a nutritional risk (NRS score ≥ 3 points) rate of 53.75% (86 cases). No nutritional risk (NRS score <3 points) 46.25% (74 cases). The nutritional risk rate of patients aged> 50 years old was higher than that of patients <50 years old, the difference was statistically significant (χ ~ 2 = 7.689, P <0.05), while there was no significant difference in nutrition risk between different BMI patients (χ ~ 2 = 5.365, P> 0.05); 66 of 86 patients with nutrition risk received nutrition support intervention (nutrition support group) and 20 patients did not receive nutrition support intervention (no nutrition support group). The levels of ALB, HB and PA in the three groups without nutritional risk (control group), nutritional support group and without nutritional support group had no significant difference before the first chemotherapy (all P> 0.05); after the first chemotherapy Nutritional risk (control group), nutritional support group patients after chemotherapy serum ALB, HB, PA levels were significantly higher than those without nutritional support group (all P <0.05), while the control group, nutritional support group after chemotherapy serum ALB, HB, PA (P> 0.05). There was no significant difference in the incidence of chemotherapy-induced adverse reactions between the nutritional support group and the non-nutritional support group (P> 0.05). The incidence of anemia in the nutritional support group was significantly lower than that of the nutritional support group No nutrition support group (P = 0.024). Conclusion Gastric cancer patients with a large proportion of nutritional risk, nutritional support for this intervention can significantly improve the patient’s nutritional status, reduce the incidence of anemia.