目的基于PG-SGA评定量表的营养干预在胃部肿瘤患者中的评价及应用效果。方法选取江苏省苏北人民医院2016年10月至2018年10月收治的胃部恶性肿瘤患者125例，采用PG-SGA对患者进行营养评估，分析不同年龄、性别、BMI的患者PG-SGA评分结果。采取随机数字表法进行单纯随机分组，将评定量表中PG-SGA≥4分患者随机分为营养干预组和对照组，营养干预组患者予以营养宣教+营养干预，对照组给予营养宣教。分别比较两组患者第1～3周的日摄入能量、蛋白质水平，以及3周后体重变化等营养指标。结果 两组不同年龄、性别患者PG-SGA评分比较，差异无统计学意义（P>0.05），不同BMI患者PG-SGA评分在4~8分及≥9分范围内比较，差异有统计学意义（P<0.05），营养干预组患者第1～3周的日摄入能量、蛋白质高于对照组患者，3周后对照组体重变化（丢失）高于干预组，干预组白蛋白、总蛋白、血红蛋白等水平高于对照组，红细胞计数高于对照组，差异均具统计学意义（P<0.05）。结论PG-SGA可以较好地反映胃恶性肿瘤患者的营养状况，营养干预治疗可以改善胃部恶性肿瘤患者的营养状况。
Abstract
ObjectiveTo evaluate the effect of nutritional intervention on gastric cancer patients based on PG-SGA rating scale. MethodsA total of 125 patients with gastric cancer were admitted to Subei Peoples Hospital of Jiangsu province were selected from October 2016 to October 2018. PG-SGA was used for nutritional assessment, and PG-SGA scores of patients with different ages, genders and body mass index were analyzed. Patients of grade B （4-8 scores） and grade C in the rating scale were randomly divided into the nutritional intervention group or the control group by simple random grouping. Patients in the nutritional intervention group were given nutritional education + nutritional intervention, while patients in the control group were given only nutritional education. The energy intake, protein level in the body and red blood cell count and other nutritional indexes of the patients in the two groups were compared on the first and third week after admission. ResultsPG-SGA scores of patients with different ages and genders were compared between the two groups, and the differences were not statistically significant （P>0.05）. When comparing the BMIs and PG-SGA scores, significant differences were found in patients with 4-8 scores or ≥9 scores （P<0.05）. The daily energy and protein intake in the nutritional intervention group was higher than that in the control group from week 1-3. The weight change （loss） in the control group was higher than that in the intervention group at week 3. The levels of albumin, total protein and hemoglobin in the intervention group were higher than that in the control group. The red blood cell count was higher than that in the control group. All above differences were statistically significant （P<0.05）. ConclusionPG-SGA assessment scale can reflect the nutritional status of patients with malignant tumor of the stomach, nutritional intervention can improve the nutritional status of patients with malignant tumor of the stomach.
关键词
肿瘤患者主观整体营养评估 /
营养干预 /
胃恶性肿瘤
Key words
Patient-generated subjective global assessment /
Nutrition intervention /
Gastric neoplasms
{{custom_sec.title}}
{{custom_sec.title}}
{{custom_sec.content}}
参考文献
1.Herszényi L, Tulassay Z. Epidemiology of gastrointestinal and liver tumors. Eur Rev Med Pharmacol Sci. 2010；14（4）:249-258.
2.World Health Organization. Global data on incidence of oral cancer （maps）. Geneva: WHO. 2015.
3.Jemal A, Bray F, Center MM, et al. Global cancer statistics. CA Cancer J Clin. 2011；61（2）:69-90.
4.Kondrup J, Rasmussen HH, Hamberg O,et al. Nutritional risk screening （NRS 2002）: a new method based on an analysis of controlled clinical trials. Clin Nutr. 2003；22（3）:321-336.
5.Abbott J, Teleni L, Mckavanagh D, et al. Patient-generated subjective global assessment short form （PG-SGA SF） is a valid screening tool in chemotherapy outpatients. Support Care Cancer. 2016；249（9）:3883-3887.
6.于康, 周晓容, 郭亚芳. 恶性肿瘤住院患者营养风险和营养不足发生率及营养支持应用状况调查. 肿瘤学杂志. 2011；17（6）:408-411.
7.杨家君, 黄学军, 邓俊晖. PG-SGA在常见消化道恶性肿瘤患者中的应用研究. 肿瘤代谢与营养电子杂志. 2017；4（2）:189-193.
8.Yordy BM, Roberts S, Taggart HM. Quality improvement in clinical nutrition: screening and mealtime protection for the hospitalized patient. Clin Nurse Spec. 2017；31（3）:149-156.
9.Ottery FD. Rethinking nutritional support of the cancer patient: the new field of nutritional oncology. Semin Oncol. 1994；21（6）:770-778.
10.Kwang AY, Kandiah M. Objective and subjective nutritional assessment of patients with cancer in palliative care. Am J Hosp Palliat Care. 2010；27（2）:117-126.
11.Oates J, Clark JR, Read J, et al. Integration of prospective quality of life and nutritional assessment as routine components of multidisciplinary care of patients with head and neck cancer. ANZ J Surg. 2008；78（1-2）:34-41.
12.Phippen NT, Lowery WJ, Barnett JC, et al. Evaluation of the patient-generated subjective global assessment （PG-SGA） as a predictor of febrile neutropenia in gynecologic cancer patients receiving combination chemotherapy a pilot study. Gynecol Oncol. 2011；123（2）:360-364.
13.许静涌, 蒋朱明. 2015年ESPEN营养不良（不足）诊断共识、营养风险及误区. 中华临床营养杂志. 2016；24（5）:261-265.
14.CSCO肿瘤营养治疗专家委员会. 恶性肿瘤患者的营养治疗专家共识. 临床肿瘤学杂志. 2012；17（1）:59-73.
15.Drissi M, Cwieluch O, Lechner P, et al. Nutrition care in patients with cancer: a retrospective multicenter analysis of current practice - Indications for further studies. Clin Nutr. 2015；34（2）:207-211.
16.李静, 毛志音, 李怡霖. 患者自评-主观全面评定量表及营养干预在胃肠道肿瘤患者中的应用效果. 中国全科医学. 2017；7（20）:144-145.
17.刘妮,方玉,李子禹,等. 营养风险筛查和主观整体评估在胃肠肿瘤病人围手术期中的应用及临床意义. 肠外与肠内营养. 2016；23（6）:346-350.
18.Isenring E, Bauer J, Capra S. The scored patient-generated subjective global assessment （PG-SGA） and its association with quality of life in ambulatory patients receiving radiotherapy. Eur J Clin Nutr. 2003；57（2）:305-309.
19.Guptn D, Lis CG, Granick J, et al. Malnutrition was associated with poor quality of life in colorectal cancer: a retrospective analysis. J Clin Epidemiol. 2006；59（7）:704-709.
20.Pan H, Cai S, Ji J, et al. The impact of nutritional status, nutritional risk, and nutritional treatment on clinical outcome of 2248 hospitalized cancer patients: a multi-center, prospective cohort study in Chinese teaching hospital. Nutr Cancer. 2013；65（1）:62-70.
21.Zhang L, Lu Y, Fang Y. Nutritional status and related factors of patients with advanced gastrointestinal cancer. Bri J Nutr. 2014；111（7）:1239-1244.
22.贺英,林欣,刘莉,等. 重庆市某医院常见恶性肿瘤住院患者营养状况调查. 肿瘤代谢与营养电子杂志. 2017；4（1）:45-50.
23.Wu Q, Yu JC, Kang WM, et al. Short-term effects of supplementary feeding with enteral nutrition via jejunostomy catheter on post-gastrectomy gastric cancer patients. Chin Med J. 2011；124（20）:3297-3301.
24.Qiu M, Zhou YX, Jin Y, et al. Nutrition support can bring survival benefit to high nutrition risk gastric cancer patients who received chemotherapy. Support Care Cancer. 2015；23（7）:1-7.
25.石汉平.营养不良的五阶梯治疗.肿瘤代谢与营养电子杂志. 2015；2（2）:29-33.
PDF(492 KB)
