目的 探索医学定制膳食(HDMTM)对转移性肺癌患者营养状况、疲劳感及生活质量的影响。 方法 前瞻性选取武 汉市第三医院 2021 年 6 月至 2023 年 6 月期间收治的 108 例转移性肺癌患者,根据随机数字表法分为两组,对照组 54 例采用 常规营养支持,干预组 54 例采用 HDMTM 支持,干预后,比较两组营养状况[血清白蛋白(ALB)、总蛋白( TP)、血红蛋白 (Hb)]、肺功能[第 1 秒用力呼气容积(FEV1 )、用力肺活量(FVC)、每分钟最大通气量(MVV)]、癌因性疲乏评分、肺癌特异性 生活质量评估表(FACT-L)评分。 结果 两组患者经干预 14 d 后,营养状态、肺功能均较治疗前有所改善,癌因性疲乏评分有 所降低,FACT-L 评分有所升高,差异均有统计学意义(P<0. 05)。 干预组干预后 14 d 的 FEV1(92. 84±4. 52)%、MVV(91. 29± 5. 45)L/ min、FVC(3. 55±0. 39)L、Hb(111. 12±6. 57)g / L、ALB(43. 11±4. 58) g / L、TP(69. 78±3. 16) g / L 优于对照组,差异有统 计学意义(P<0. 05),干预后 14 d 的情感疲乏(4. 85±1. 22)分、行为疲乏(3. 13±1. 52)分、躯体疲乏(3. 38±1. 19)分、认知疲乏 评分(3. 15±1. 14)分均低于对照组,差异有统计学意义(P<0. 05),干预后 7 d FACT-L 评分( 82. 85±5. 25) 分、干预后 14 d FACT-L 评分(93. 35±4. 25)分高于对照组,差异有统计学意义(P<0. 05)。 结论 HDMTM 更具有针对性、科学性,相比于常规 营养治疗,在转移性肺癌患者中效果更为明显,不仅能够改善患者肺功能、营养状态,促进病情恢复,还能够缓解疲乏感,提高 生活质量,利用价值更高。

Objective To explore the effects of medical customized diet HDMTM on nutritional status fatigue and quality of life in patients with metastatic lung cancer. Method A prospective selection of 108 patients with metastatic lung cancer admitted to Wuhan Third Hospital between June 2021 and June 2023 was conducted. They were randomly divided into two groups using a random number table method. The control group 54 cases received routine nutritional support while the intervention group 54 cases received HDMTM support. After intervention the nutritional status of the two groups serum albumin ALB total protein TP hemoglobin Hb lung function forced expiratory volume in one second FEV1 forced vital capacity FVC maximum ventilation volume per minute MVV cancer - related fatigue score and lung cancer specific quality of life assessment FACT - L score were compared. Result After 14 days of intervention the nutritional status and lung function of the two groups of patients improved compared to before treatment. The cancer-related fatigue score decreased and the FACT-L score increased with statistical significance P<0. 05 . After 14 days of intervention the improvement of FEV1 92. 84 ± 4. 52 % MVV 91. 29 ± 5. 45 L/ min FVC 3. 55 ± 0. 39 L Hb 111. 12 ± 6. 57 g / L ALB 43. 11 ± 4. 58 g / L and TP 69. 78 ± 3. 16 g / L in the intervention group was better than that in the control group with statistical significance P<0. 05 . The scores of emotional fatigue 4. 85 ± 1. 22 behavioral fatigue 3. 13 ± 1. 52 physical fatigue 3. 38 ± 1. 19 and cognitive fatigue 3. 15 ± 1. 14 after 14 days of intervention were lower than those of the control group with statistical significance P< 0. 05 . The FACT-L score 82. 85 ± 5. 25 and FACT-L score 93. 35 ± 4. 25 after 7 days of intervention were higher than those of the control group with statistical significance P< 0.05. Conclusion HDMTM is more targeted and scientific. Compared to conventional nutritional support it has a more significant effect in patients with metastatic lung cancer. It can not only improve lung function and nutritional status promote disease recovery but also alleviate fatigue improve quality of life and have higher utilization value.