肿瘤患者抗肿瘤治疗前的营养状况:单中心前瞻性观察研究

O. Obukhova, A. Snegovoy, I. Kurmukov, E. Kolomiets, M. G. Toms, M. Khulamkhanova, R. Yagubyan
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引用次数: 1

摘要

背景:营养不良是癌症患者常见的医学问题,影响抗肿瘤治疗的效果。目的:探讨肿瘤医院患者营养不良问题。材料与方法:观察性研究纳入80例患者(男性30例,年龄51.613.6岁),均在抗肿瘤治疗(内科/外科)前接受检查。评估患者近6个月体重指数(BMI)、体重减轻(WL)、入院前食欲下降、食物摄入减少原因、体力活动、分诊、肿瘤分期、诊断时间、治疗情况、总蛋白(TP)、白蛋白(白蛋白)、绝对淋巴细胞计数(ALC)。采用SPSS13.0软件对数据进行分析。结果以平均SD表示。结果:BMI为25.35.4 kg/m2, WL为9.00.1%。最常见的病理是食管癌/胃癌(31%),第四期(77%)。25%的PTS患者在最近612个月内接受过治疗,60%的PTS患者接受过化疗,其中36%的PTS患者接受过一线化疗。只有13%的患者额外使用了肠内营养。75%的患者出现了不必要的食欲下降。大多数(34%)无法解释WL的原因,31%的人报告恶心/呕吐,19%的人提到厌食;13%的患者表现为化疗毒性(吞咽困难、口炎),3%的患者因疼痛综合征而不能正常进食。在60例非故意减肥患者中,54例(67.5%)的平均WL为14.19.1%。WL在5分(6.25%)上达到5%,在14分(17.5%)上达到10%,在35分(43.75%)上超过10%。46%的人保持了日常活动,80%的人认为在治疗中加入营养计划是有用的。TP为63.58.1 g/l,白蛋白为34.97.4 g/l, ALC为1.60.6109 g/l。结论:癌症患者具有恶病质发展的直接先决条件,根据我们的研究,6.25%的患者处于恶病质前期阶段,61.25%的患者在纳入研究时已经有恶病质。虽然他们的代偿能力相当高,指派额外的营养支持是管理这些病人的一个组成部分。然而,根据我们的数据,只有十分之一的患者使用了某种营养支持。然而,在抗肿瘤治疗的情况下,营养状况评估必须是强制性的,以解决营养支持的问题。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
The Nutritional Status of Oncological Patient Prior to Antitumor Treatment: Single-Center Prospective Observational Study
Background: Malnutrition is a frequent medical problem of cancer patients (pts) that negatively impacts of results of antitumor treatment. Aim: To study the problem of malnutrition in cancer hospital. Materials and methods: The observational study included 80 pts (30 males, age 51.613.6 years) who underwent examination before antitumor treatment (medical/surgical). Body mass index (BMI), weight loss (WL) over last 6 months, decrease in appetite before admission, reasons for decrease in food intake, physical activity, nosology, cancer staging, the time to diagnosis, therapy status, total protein (TP), albumin, absolute lymphocyte count (ALC) were evaluated. The data were analyzed by SPSS13.0 software. The results were expressed as mean SD. Results: The BMI was 25.35.4 kg/m2, WL 9.00.1%. The most common pathology were esophageal/gastric cancer (31%), stage IV (77%). 25% had received treatment within the last 612 months, 60% of the pts had received chemotherapy, of whom 36% had received 1st-line chemotherapy. Only 13% had additionally used enteral nutrition. An unwanted reduction of appetite was observed in 75% of pts. Most of them (34%) could not explain the reason of WL, 31% reported nausea/vomiting, 19% referred to anorexia; 13% showed consequences of chemotherapy toxicity (dysgeusia, stomatitis), 3% could not eat properly due to the pain syndrome. Of 60 patients who lost weight unintentionally, 54 (67.5%) had an average WL 14.19.1%. WL up to 5% was in 5 pts (6.25%), up to 10% in 14 pts (17.5%) and in 35 pts (43.75%) more than 10%. 46% retained their usual daily activity, 80% deemed it useful to include a nutritional program in the treatment. The concentration of TP was 63.58.1 g/l, albumin 34.97.4 g/l, ALC 1.60.6109/l. Conclusions: Cancer patients have direct prerequisites for the development of cachexia, and, according to our study, 6.25% of patients were at the stage of precachexia, and 61.25% already had cachexia at the time of inclusion in the study. Although their compensatory capacity is quite high, the appointment of additional nutritional support is an integral component of the management of these patients. However, according to our data, only one tenth of patients used some kind of nutritional support. Nevertheless, in case of antitumor treatment, nutritional status evaluation must be mandatory in order to address the issue of nutritional support.
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