目的 探讨蛋白质摄入量对头颈部肿瘤患者放化疗期间营养状况、人体成分及生活质量的影响。方法83例头颈 部肿瘤患者均采用患者主观整体评估方法对放疗前后的营养状态进行评估以及营养干预（饮食指导、ONS、PN），按实际蛋白质摄入量0.8g/(kg·d)为界分为A组[≥0.8g/(kg·d)]和B组[＜0.8g/(kg.d)]，采用生物电阻抗法观察两组患者放疗前后的人体成分变化及肿瘤患者生命质量测定表（EORCT QLQ-C30）观察两组患者放疗前后生活质量的变化。结果 两组患者放疗前营养不良发生率无统计学差异（P≥0.5），放疗结束后A组营养不良发生率、握力前后变化值明显低于B组，差异有统计学差异，P＜0.05；体成分变化方面，A组在体重变化、体重变化百分比、BMI变化、体脂变化百分比、去脂体重变化、肌肉质量变化、去脂体重指数变化方面均明显低于B组，差异有统计学意义，P＜0.05；两组患者放疗前生活质量评分没有统计学差异，放疗结束后A组在疲劳、失眠、食欲丧失、疼痛、总体生活质量变化方面均优于B组，差异有统计学意义，P＜0.05。结论 应对头颈部肿瘤患者放疗期间进行全程的营养干预，重视头颈部肿瘤患者放化疗期间蛋白质、能量的摄入，可改善患者的营养状态及体力，对体成分变化、提高患者的生活质量有益处。

Objective To explore the effect of protein intake on the nutritional status, body compositionp and quality of life ofpatients with head and neck cancer treated by radiotherapy. MethodsThe patient-generated subjective global assessment method was adopted to evaluate the nutritional status of 83 patients with head and neck cancer before and after radiotherapy. Nutrition interventions (dietary guidance, ONS, PN) were also totally employed during their therapy. According to theiractual protein intake, these patients were divided into two groups, group A [≥0.8g/(kg·d)] and group B [<0.8g/(kg·d)]. The status of nutrition, assessment of body composition and quality of life before and after radiotherapy in two groups of patients were compared. ResultsThe incidence of malnutrition in two groups had no statistic difference before radiotherapy (P≥0.5). After radiotherapy, the incidence of malnutrition and the change of the grip force in A group were significantly lower than that in B group (P<0.05); Changes in body composition in A group were significantly lower than in B group, such as body weight, percentage change in body weight, BMI, percentage of fat body mass change, fat-free mass change, muscle mass change, and FFMI index (P<0.05); The quality of life scores in two groups had no statistic differencebefore radiotherapy; after the radiotherapy the changes of fatigue, insomnia, loss of appetite, pain, the overall quality of life in group A are better than in group B (P<0.05). ConclusionNutritional interventions can effectively maintain the nutritional status, improve continuously the physical strength and the quality of life in head and neck cancer patients with radiotherapy.