摘要
目的了解胃癌根治术后接受化疗患者化疗末期的营养状况，并分析其主要影响因素，为制订有针对性的护理干预提供参考依据。方法运用患者主观整体营养状况评估量表、胃癌患者化疗不良反应调查表等收集2014年9月至2016年3月行胃癌根治术后接受完整化疗患者的临床资料。结果共纳入103例患者，患者化疗前及化疗末期营养不良发生率分别为45．63％（47／103）、73．79％（76／103），差异有统计学意义（χ^2=16．97，P〈0．05）。患者化疗前营养评估总得分、血红蛋白水平及体质量指数分别为（3．64±0．78）分、（124．11±21．78）g，L、（21．29±2．77）kg／m^2，化疗末期分别为（8．07±3．75）分、（108．54±11．68）g／L、（20．29±2．68）kg／m^2，差异有统计学意义（t=11．74、6．39、2．63，均P〈0．05）。患者情绪低落处于较高水平，为65．05％（67／103），食欲减退在化疗末期所占比例高达75．73％（78／103）。Logistic回归分析结果显示文化程度、食欲减退及化疗期间接受肠外营养支持为影响患者化疗末期营养状况的主要因素。结论胃癌根治术患者化疗末期营养状况较差，医护人员应关注文化程度低的患者；给予患者及家属有针对性的饮食咨询、纠正误区，增强其对膳食知识的了解；加强化疗并发症的管理，减少影响患者营养状况的不良因素，改善患者的营养状况。
Objective To explore the nutritional status of radical gastrectomy patients during the late course of chemotherapy and its main influencing factors, providing reference for the development of targeted nursing intervention. Methods The Scored Patient-Generated Subjective Global Assessment, The Chemotherapy Side Effects of Patients with Gastric Cancer Questionnaire were used to collect clinical data that received complete chemotherapy after radical surgery from September 2014 to March 2016. Results A total of 103 cases finally involved in this study. The incidence of malnutrition in patients during pre-chemotherapy and late course of chemotherapy was 45.63% （47/103） and 73.79% （76/103） respectively, and there was significant difference （χ^2=16.97, P〈0.05）. The nutritional assessment score, the hemoglobin levels and body mass index of patients pre-chemotherapy was （3.64±0.78） points, （124.11± 21.78） g/L, （21.29±2.77） kg/m^2, （8.07±3.75） points, （108.54± 11.68） g/L, （20.29±2.68） kg/m2 late course of chemotherapy and there were significant differences（t =-11.74, 6.39, 2.63, all P〈0.05）. The symptom of depression was at a higher level 65.05%（67/103）, patients with anorexia in late course of chemotherapy accounted as much as 75.73%（78/105）. Logistic regression analysis showed that educational level, loss of appetite and parenteral nutrition were the main factors which influenced the nutritional status of patients during the late course of chemotherapy. Conclusions With the increase in the number of chemotherapy, the nutritional status of the patient is getting worse. The study suggests medical personnel should pay more attention to the patients with low educational level, give patients and their families targeted diet counseling, correct the mistaken conceptions thus enhance their understanding of dietary knowledge. Strengthening the management of complications during chemotherapy, reducing the adverse factors that affect the patient＇s nutritional status to improve the nutritional status of patients.
出处
《中国实用护理杂志》
2017年第20期1530-1535,共6页
Chinese Journal of Practical Nursing
基金
河南省高等学校重点科研项目（15A320026）
关键词
药物疗法
胃癌根治术
患者
营养评估
影响因素
Drug therapy
Radical gastrectomy
Patients
Nutrition assessment
Influence factor
