目的 调查重庆市人民医院常见恶性肿瘤住院患者的营养状况。方法 采用营养风险筛2002、PG-SGA、体格测 量、实验室检测等方法对重庆市人民医院自 2015 年 5 月 4 日至 2015 年 12 月 31 日的 311 例 16 种常见恶性肿瘤住院患者进 行营养风险筛查、营养评估，并调查这些患者的营养治疗情况。结果 311 例患者中，有营养风险（NRS 2002 ≥ 3 分）的 为 44.37%（138/311）。以 PG-SGA 评分评估患者营养状况，结果显示，52.73%（164/311) 的肿瘤患者存在中度营养不良 (PG-SGA ≥ 4 分 )，其中31.19%（97/311）为重度营养不良（PG-SGA ≥ 9 分 )；消化道肿瘤患者营养不良的发生率比非消 化道肿瘤患者高（65.41% vs. 43.26%，χ2=13.417，P＜0.001）；多元线性回归分析体质指数、血清白蛋白、血清前白蛋白、 最近 1 个月体重下降百分比、左小腿围、非利手握力与 PG-SGA 评分之间有相关性（P 均＜ 0.001），其中左小腿围、最近 1 个月体重下降百分比与PG-SGA 评分相关性最好（回归系数B 分别为-0.872、0.861，P ＜ 0.001 ），血红蛋白、上臂肌 围与 PG-SGA 评分相关性不具统计学意义（P 分别为0.268，0.218）；中、重度营养不良患者的营养治疗率仅为43.90% （72/164），营养治疗以单独肠外营养治疗为主，占 91.7%（66/72），肠内营养联合肠外营养占 6.94%（5/72），单独肠内 营养治疗仅1 例，占营养治疗患者的1.38%（1/72）。结论 52.73% 的常见恶性肿瘤患者存在中、重度营养不良。PG-SGA 评分是评估肿瘤患者营养不良简便、有效的工具，营养不良的患者营养治疗率低，且以肠外营养为主，肠内营养治疗率极低。 建议对恶性肿瘤患者进行入院后的营养风险筛查以及包括 PG-SGA 评分在内的全面营养评估，并给予正确的营养治疗。

Objective To investigate the nutritional status of hospitalized patients with common malignant tumor in Chongqing General Hospital. Methods From May 4th 2015 to Dec 31st 2015, we enrolled 311 patients with cancer hospitalized for treatment in Chongqing General Hospital. These patients were diagnosed with one of the following 16 different types of malignant tumors: lung cancer, gastric cancer, liver cancer, colorectal cancer, breast cancer, esophageal cancer, cervical cancer, endometrial cancer, nasopharyngeal carcinoma, malignant lymphoma, leukemia, pancreatic cancer, ovarian cancer, prostate cancer, bladder cancer and brain tumor. Nutritional risk screening 2002 (NRS 2002), patient-generated subjective global assessment (PG-SGA), anthropometric measurements, and laboratory examination were used to evaluate the nutritional risk or nutritional status. We also investigated the nutritional therapy of these cancer patients. Results According to the NRS 2002 score, 138 patients (44.37%) had the nutritional risk (score≥3); With PG-SGA score as standard, 52.73% (164/311)of the cancer patients were malnutrition (PG-SGA≥4), and 31.19% (97/311) were severe malnutrition (PG-SGA≥9). The rate of malnutrition for gastrointestinal cancer patients is higher than Nongastrointestinal cancer patients (65.41% vs. 43.26%, χ2=13.417, P<0.001). Multiple linear regression analysis, PG-SGA scores and body mass index (P<0.001), serum albumin (P<0.001), prealbumin (P<0.001), the percentage of weight loss in the recent 1 month(P<0.001), calf circumference (left side, P=0.001)，non-profit grip strength (P=0.001) were correlated, in which left calf circumference, last 1 month weight loss percentage correlation with PG-SGA scoring the best (regression coefficient b-0.872, 0.861, P<0.001, respectively), hemoglobin, arm muscle circumference and PG-SGA scores correlated without statistical significance (P, 0.268, 0.218, respectively); 43.90% (72/164) of all the moderately and severely malnourished patients received nutritional therapy, 91.7% (66/72) were receive only parenteral nutrition, 6.94% (5/72) were received enteral and parenteral nutrition, just one case (1.38%, 1/72) were received only enteral nutrition. Conclusions 52.73% of the common malignant tumor patients enrolled in the present study were malnutrition. PG-SGA is an effective tool to assess malnutrition in cancer patients, it is recommended to conduct routine assessment of cancer patients at the beginning of admission. Nutritional therapy of malignant tumor patients with malnutrition is very low, especially enteral nutritional support. Suggestions for patients with malignant tumor after admission nutritional risk screening, and comprehensive nutritional evaluation, including PG-SGA score, and to give the right nutritional therapy.