摘要：目的 调查肿瘤放化疗住院患者营养风险、营养不足发生率及营养支持情况，为合理应用营养支持提供依据。方法 选取 2010 年 3 月至 2011 年 2 月在某三级甲等肿瘤专科医院放疗科住院的 80 例放化疗患者。应用营养风险筛查 2002（NRS 2002）在入院后 48 小时内及出院时调查营养风险和营养不足的发生率，同时在出院时调查营养支持的应用状况。结果 80 例放化疗患者，鼻咽癌 41 例，食管癌 16 例，口腔癌 12 例，胰腺癌 4 例，胃癌 2 例，直肠癌 3 例，胆管癌 2 例。其中 67 例为同步放化疗患者，13 例为单纯放疗患者。入出院时总的营养风险分别为 38.75% 和 81.25%，营养不足发生率分别为 23.75% 和 40%，有营养风险的 31 例患者中，有 20 例（64.52%）的患者接受了营养支持，营养支持以 PN 为主；有营养风险组和无营养风险组Ⅲ度以上的骨髓抑制分别为 29.0%（9/31）和 26.5%(13/49) ，差异无统计学意义（P ＜ 0.05），但Ⅳ度贫血和血小板减少仅出现在有营养风险组。 结论 肿瘤放化疗患者入院时营养风险和营养不足发生率较高，且出院时营养风险及营养不足较入院时明显增加。营养不足患者的放化疗副反应有增加的趋势，且营养支持不尽合理。因此，应重视放疗患者营养风险的动态评估，并由营养支持小组根据评估结果制定合理的营养支持方案。

Abstract: Objective To explore the prevalence of nutritional risk, undernutrition and application of nutritional support in cancer patients during chemoradiotherapy. Methods A total of 80 were enrolled from March 2010 to February 2011 .Nutritional risk screening(NRS 2002) was performed on first 48 hours incharge and the discharged day, Nutritional support was evaluated on the discharged day too. Results Overall prevalence of nutritional risk and undernutrition on first 48 hours incharge was 38.75% , 23.75% respectively, the prevalence of nutritional risk and undernutrition on the discharged day was 81.25%,40% respectively. Totally 20 patients with NRS≥3 were received nutritional support. Grade 3 or higher myelosuppression occurrence were 29%(9/31), 26.5%(13/49) among patients with NRS≥3 and NRS <3 respectively . Grade 4 anemia and thrombocytopenia only occurred in patients with NRS≥3. Conclusions A large proportion of cancer patients is at nutritional risk or undernutrition during chemoradiotherapy .The application of nutrition support is inappropriate. Assessing the nutrition risk dynamically, and carrying out effective nutrition support are the key points to prevent chemoradiotherapy patients from undernutrition.