营养影响症状(NIS)是疾病本身和疾病治疗过程中出现的、可以影响患者营养状况的一组症状的统称,包括疼痛、 口干、食欲下降、便秘、饱胀、腹泻、口腔溃疡、恶心、呕吐、气味改变、味觉改变、吞咽困难等,不同症状对营养的影响大小不同。 症状数量多少,即症状负荷是影响营养状况的重要因素。 患者主观整体评估(PG-SGA)是目前研究肿瘤患者 NIS 最常用的量 表,头颈部肿瘤患者症状核对清单(HNSC)是头颈部肿瘤患者,特别是接受放射治疗(简称放疗)患者的专门工具。 埃德蒙顿 症状评估系统(ESAS)可用于一般良、恶性肿瘤患者。 NIS 的范畴不仅受量表的影响,不同疾病、不同肿瘤、不同分期、不同个 体、不同治疗患者的 NIS 差异较大。 总体上,恶性肿瘤 NIS 多于良性肿瘤,进展期肿瘤多于早期肿瘤,男性多于女性,65 岁及 以上患者多于 65 岁以下者,放疗多于手术和化疗。 NIS 不仅导致摄食减少、体重丢失,而且是导致机体功能障碍的关键决定 因素,严重影响临床结局及生存时间。 NIS 越多、积分越高,患者预后越差。 NIS 管理包括症状本身的管理及营养管理,需要多 学科团队共同努力。

Nutrition impact symptoms NIS are a group of symptoms caused by the disease or its treatment and can affect a patient􀆳s nutritional status. These symptoms include pain dry mouth decreased appetite constipation satiety diarrhea oral ulcer nausea vomiting odor changes taste changes and difficulty swallowing. Different symptoms have different effects on nutrition. The number of symptoms that is symptom load is a more critical factor affecting nutritional status. Patient generated subjective global assessment PG- SGA is the most commonly used scale to study NIS in cancer patients. The Head and Neck Patient Symptom Checklist HNSC is a special tool for patients with head and neck cancer especially those receiving radiotherapy. The Edmonton Symptom Assessment System ESAS is suitable for patients with benign and malignant diseases. The NIS is reflected by the assessment scales and varies dramatically among diseases tumors stages individuals and medical treatments. Overall NIS is more common in patients with malignant tumors patients with more advanced tumors male patients patients over 65 years old and patients who underwent radiotherapy. A higher number or score of NIS indicates a worse prognosis for the patient. The management of NIS including the management of the symptoms and nutrition requires efforts from a multidisciplinary team.