目的 基于肿瘤患者营养管理系统探索多学科团队在食管癌放化疗治疗中营养管理的应用价值。 方法 选取 2020 年 1 月至 12 月南通大学附属医院放疗科食管癌住院患者 101 例,按照随机数字法分为对照组 50 例和干预组 51 例。 对照组 患者接受常规治疗和护理。 干预组在常规治疗和护理的基础上建立以护理人员为主导的多学科团队(MDT),基于肿瘤患者 营养管理系统构建“入院评估—结果评定—营养干预—治疗监护—营养随访”的营养管理流程对患者进行营养管理。 比较两 组患者的临床营养指标和临床结局,并进行“成本-效果比(C/ E)”分析。 结果 干预组患者的淋巴细胞计数、总蛋白、白蛋白、 前白蛋白变化均显著低于对照组(P<0. 05)。 干预组肿瘤放疗相关并发症发生率显著低于对照组(P<0. 05)。 干预组肿瘤患 者生命质量测定量表(FACT-G)评分显著高于对照组(P<0. 05),干预组患者的美国东部肿瘤协作组(ECOG)体力状况评分显 著低于对照组(P<0. 05)。 干预组患者的人均住院费用显著低于对照组(P<0. 05)。 干预组和对照组临床有效率的 C/ E 分别 为 262. 7 和 498. 6。 干预组和对照组生命质量评价的 C/ E 分别为 245. 5 和 353. 9,干预组均低于对照组。 结论 基于肿瘤患者营养管理系统下多学科团队对食管癌患者放化疗期间营养管理可显著改善患者的营养状况和生活质量,减少患者的住院费 用,减少放疗相关并发症的发生率,具有良好的 C/ E 和经济学价值。

Objective To explore the application value of nutrition management during radiotherapy and chemotherapy for esophageal cancer in multiple disciplinary team by the nutrition management system. Method Between January and December 2020 101 patients with esophageal cancer in the Department of Radiotherapy at Affiliated Hospital of Nantong University were selected. They were randomly divided into control group with 50 patients and intervention group with 51 patients according to the random number method. The control group was given conventional treatment and nursing. The study group established a nurse - led multiple disciplinary team based on the nutrition management system built 􀆵Admission assessment—results evaluation—nutrition intervention—treatment monitoring—nutrition tracking nutrition management process. Clinical nutritional indicators Clinical outcomes were compared between the two groups and cost-effectiveness ratio was conducted. Result The changes of lymphocyte count total protein albumin prealbumin in the intervention group were significantly lower than those in the control group P<0. 05 . The incidence of radiation-related complications in the intervention group was significantly lower than those in the control group P<0. 05 . FACT-G score in the intervention group was significantly higher than those in the control group P<0. 05 ECOG score in the intervention group was significantly lower than those in the control group P<0. 05 . The hospitalization expenses per capita in the intervention group were significantly lower than those in the control group P<0. 05 . C/ E of clinical response rate were 262. 7 and 498. 6 and C/ E of functional assessment were 245. 5 and 353. 9 in 2 groups C/ E in the intervention group ware lower than those in the control group. Conclusion Nutrition management during radiotherapy and chemotherapy for esophageal cancer in multiple disciplinary team by the nutrition management system can significantly improve the patient􀆳s nutritional status and quality of life reduce the hospitalization expenses decrease the incidence of related complications. It has good cost-effectiveness ratio and economic value.