目的 探究营养干预对头颈部肿瘤患者根治性放化疗期间营养状况及身心状态的影响。 方法 选取 2018 年 6 月至 2019 年 12 月南京鼓楼医院肿瘤科收治的头颈部肿瘤患者 61 例。 采用单纯随机分组方法将观察对象分为两组,干预组( n = 29)为营养师介入的临床诊疗模式,对照组(n = 32)为常规临床诊疗模式。 所有患者均采用根治性同步放化疗方案。 比较两 组的营养摄入量、营养状况、疼痛程度及生活质量的变化。 结果 在能量、蛋白质摄入方面,两组的能量和蛋白质摄入量均减 少,对照组减少幅度更大,差异有统计学意义(P<0. 05);在疼痛、心理及生活质量方面,干预组视觉模拟评分法评分、广泛性焦 虑量表(GAD-7)焦虑评分及 Karnofsky 功能状态(KPS)评分均优于对照组,差异有统计学意义(P<0. 05);营养指标方面,除了 C 反应蛋白两组差异无统计学意义外,干预组患者体重、骨骼肌、血清总蛋白及血清白蛋白指标均优于对照组,差异有统计学 意义(P<0. 05)。 结论 在头颈部肿瘤治疗中,营养师介入的临床营养诊疗模式不仅有助于缓解患者身心状态的恶化,还有助 于改善营养相关指标。

Objective To explore the effects of nutritional status and physical and psychological healthy state in head and neck cancer patients with nutritional interventions by dietitians. Method Seventy-two patients with head and neck cancer admitted to Nanjing Drum Tower Hospital Tumor Center from June 2018 to December 2019 were selected. According to the elimination criteria there were 61 patients randomized to either the control n = 29 or the intervention group n = 32 finally. The control group was treated with the general nutritional intervention method. In the intervention group patients adopted with diagnosis and treatment model of nutritional intervention by dietitians. Then the nutrient intaking nutritional indexes the degree of pain and quality of life were compared between the two groups. Result The energy and protein intaking of the two groups were decreased but the intervention group was better P<0. 05 . In terms of pain psychology and quality of life the VAS and GAD-7 and KPS scores of the intervention group were better P<0. 05 Except for C-reactive protein the indexes of weight skeletal muscle serum total protein and serum albumin in the intervention group were better P<0. 05 . Conclusion In the treatment of head and neck cancer the mode of clinical nutrition support diagnosis and treatment mode involving dietitians may help to alleviate the deterioration of patients' the physical and psychological healthy states in addition it may also has advantages in improving the indexes of nutritional status.