目的 探讨头颈部肿瘤患者在放疗不同时期营养相关症状对进食干扰的纵向变化,并分析营养相关症状对体重的 影响。 方法 选取 2022 年 5 月至 2023 年 12 月在重庆医科大学附属第一医院肿瘤科行放疗的头颈部肿瘤患者共 123 例,对受 试者在放疗第 1、3、5 和 7 周共计 4 个时间点进行营养相关症状和体重评估,采用广义估计方程评估营养相关症状干扰评分对 体重的影响。 结果 放疗第 1 周、第 3 周、第 5 周和第 7 周营养相关症状对饮食干扰的数量分别为 2(1,3)、5(3,7)、6(5,7)和 6 (5,8)个,不同时期比较差异有统计学意义(P<0. 001);放疗各阶段营养相关症状对进食的干扰总评分分别为(19. 70±2. 47) 分、(24. 63±4. 47)分、(27. 59±4. 71)分和(28. 56±5. 13)分,不同时期比较差异有统计学意义(P<0. 001);放疗各阶段患者体重 分别为(62. 06±9. 87)kg、(61. 73±10. 2)kg、(59. 79±9. 67)kg 和(58. 3±9. 42) kg,不同时期比较差异有统计学意义(P<0. 05); 疼痛、精力不足和味觉改变(均 P<0. 05)对体重下降有影响。 结论 头颈部肿瘤患者放疗期间会出现多个营养相关症状干扰进 食,其发生率和干扰程度随着放疗进行持续升高和加重,而体重则持续下降。 疼痛、精力不足和味觉改变对体重减轻有显著 影响。 医务人员应制订整体症状管理计划和膳食指导方案,加强效果评估。

Objective To explore longitudinal changes in nutrition impact symptoms NIS among head and neck cancer HNC patients at different stages of radiotherapy RT and further analyze the impact of NIS on weight. Method A total of 123 HNC patients were investigated in the first week third week fifth week and seventh week of RT. Generalized Estimation Equation GEE was used to estimate the impact of NIS interference scores on weight. Result During the first week third week fifth week and seventh week of radiotherapy the numbers of NIS interfering with diet were 2 1 3 5 3 7 6 5 7 6 5 8 and the total interference scores were 19. 70±2. 47 24. 63±4. 47 27. 59±4. 71 28. 56±5. 13 and the mean body weights were 62. 06±9. 87 kg 61. 73±10. 2 kg 59. 79± 9. 67 kg 58. 3±9. 42 kg respectively each showing significant differences over time P<0. 001 . NIS of pain lack of energy and taste change impacted weight reduction P<0. 05 . Conclusion The number incidence and severity of NIS that interfere with diet in patients with HNC aggravate as RT progresses. NIS of pain lack of energy and taste change had significant impacts on weight loss. Medical staff should develop a holistic symptom management plan and dietary guidance program to strengthen the evaluation of effects.