目的 探讨肝癌患者睡眠-觉醒障碍与营养不良的关系。 方法 选择 2019 年 10 月至 2021 年 10 月入南通大学附属 海安医院肿瘤科确诊肝细胞癌患者共 122 例为研究对象,入院治疗前采用皇家免费医院营养优先工具(RFH-NPT)评估营养 状况分为营养不良组 74 例(2~ 7 分)和营养正常组 48 例(0~ 1 分),采用匹兹堡睡眠质量指数(PSQI)评估睡眠状况,以 PSQI> 7 分提示睡眠-觉醒障碍。 结果 单因素比较发现,营养不良组患者年龄增大、病程延长、肿瘤 TNM 分期升高、体质指数(BMI) 减小、血清白蛋白水平下降、PSQI 总分增加,睡眠-觉醒障碍发生率增多,差异有统计学意义(P<0. 05)。 多因素 Logistic 回归 分析显示,年龄、TNM 分期和睡眠-觉醒障碍是肝癌患者营养不良的危险因素(P<0. 05)。 Spearman 检验显示,RFH-NPT 评分 与 PSQI 评分呈正相关(r = 0. 390,P<0. 001)。 结论 肝癌患者营养不良的发生率较高,与患者年龄、TNM 分期和睡眠-觉醒障 碍有关;评估肝癌患者的营养状况和睡眠-觉醒障碍对指导临床治疗具有重要意义。

Objective To investigate the relationship between sleep-wake disturbance and malnutrition in patients with liver cancer. Method A total of 122 patients with hepatocellular carcinoma into our hospital from October 2019 to October 2021 were chosed as the research objects. Before treatment the nutritional status was assessed by the Royal Free Hospital - Nutritional Prioritizing Tool RFH-NPT which was divided into 74 cases in the malnutrition group 2-7 points and 48 cases in the normal nutrition group 0- 1 point . The sleep status was assessed by the Pittsburgh Sleep Quality Index PSQI PSQI > 7 indicated sleep-wake disturbance. Result Univariate comparison showed that the malnutrition group had older age longer course of disease higher tumor TNM stage lower body mass index BMI less serum albumin level higher total score of PSQI and more incidence of sleep-wake disturbance P < 0. 05 . Multivariate Logistic regression analysis showed that age TNM stage and sleep-wake disturbance were the risk factors of malnutrition in patients with liver cancer P<0. 05 . Spearman test showed that RFH-NPT score was positively correlated with PSQI score r = 0. 390 P< 0. 001 . Conclusion The incidence of malnutrition in patients with liver cancer is high which is related to patients􀆳 age TNM stage and sleep-wake disturbance Evaluating the nutritional status and sleep-wake disturbance of patients with liver cancer is of great significance to guide clinical treatment.