CAJ | 학술논문

目的：评价食管癌患者放疗期间的营养不良风险和营养状况，探索改善食管癌患者营养状况的护理对策。方法选择2012年6月-2013年4月60例行放疗的食管癌住院患者，运用人体测量指标、实验室检查数据对患者在入院时、放疗当日、放疗后每周进行营养评估，运用欧洲营养风险筛查工具（ NRS2002）每周对患者进行营养风险筛查。结果 NRS 2002营养筛查工具评分显示食管癌患者放疗开始后营养不良风险数值逐步增加，放疗2周后评分为（2．06±1．22），与放疗前比较差异有统计学意义（t＝-2．457，P＜0．05）；放疗2周后体质指数（20．21±2．69）kg／m2、三头肌皮褶厚度（7．27±3．20）mm、上臂围（24．71±2．68）cm、总蛋白（65．50±5．25）g／L、白蛋白（38．48±5．00）g／L、淋巴细胞总数（6．55±3．42）×109／L，与入院时比较差异有统计学意义（ t值分别为3．204，2．777，3．053，7．174，5．685，12．508；P＜0．05），并在后续每周评分中各指标仍呈逐渐下降趋势；放疗2周后营养不良发生率增加，以TSF、TP、TLC进行评价时，分别为95．00％，11．67％，98．33％，与入院时比较差异有统计学意义（χ2值分别为11．800，7．792，73．024；P＜0．05）。结论食管癌患者放疗期间营养不良风险逐步增加，营养状况逐渐下降，放疗2周后营养不良发生率增加。
목적：평개식관암환자방료기간적영양불량풍험화영양상황，탐색개선식관암환자영양상황적호리대책。방법선택2012년6월-2013년4월60례행방료적식관암주원환자，운용인체측량지표、실험실검사수거대환자재입원시、방료당일、방료후매주진행영양평고，운용구주영양풍험사사공구（ NRS2002）매주대환자진행영양풍험사사。결과 NRS 2002영양사사공구평분현시식관암환자방료개시후영양불량풍험수치축보증가，방료2주후평분위（2．06±1．22），여방료전비교차이유통계학의의（t＝-2．457，P＜0．05）；방료2주후체질지수（20．21±2．69）kg／m2、삼두기피습후도（7．27±3．20）mm、상비위（24．71±2．68）cm、총단백（65．50±5．25）g／L、백단백（38．48±5．00）g／L、림파세포총수（6．55±3．42）×109／L，여입원시비교차이유통계학의의（ t치분별위3．204，2．777，3．053，7．174，5．685，12．508；P＜0．05），병재후속매주평분중각지표잉정축점하강추세；방료2주후영양불량발생솔증가，이TSF、TP、TLC진행평개시，분별위95．00％，11．67％，98．33％，여입원시비교차이유통계학의의（χ2치분별위11．800，7．792，73．024；P＜0．05）。결론식관암환자방료기간영양불량풍험축보증가，영양상황축점하강，방료2주후영양불량발생솔증가。
Objective To evaluate the risks of malnutrition and nutritional status of patients with esophageal cancer during radiotherapy , so as to explore nursing countermeasures to improve their nutritional status.Methods 60 inpatients with esophageal cancer receiving routine radiotherapy from June 2012 to April 2013 were investigated with anthropometric indicators and laboratory data for weekly nutritional evaluation on admission, during radiotherapy, and after radiotherapy.Meanwhile, the patients were conducted with Nutritional Risk Screening ( NRS2002 ) per week .Results NRS2002 score showed that the malnutrition risk values of patients with esophageal cancer gradually increased after radiotherapy .The score was (2.06 ±1.22) after 2 weeks of radiotherapy, suggesting that the difference was statistically significant (t=-2.457, P<0.05). After the radiotherapy , the scores of body mass index ( BMI ) , triceps skinfold ( TSF ) , arm circumference (AC), total protein (TP), albumin (ALB) and total lymphocyte count (TLC) were (20.21 ±2.69)kg/m2, (7.27 ±3.20)mm, (24.71 ±2.68)cm, (65.50 ±5.25)g/L, (38.48 ±5.00)g/L and (6.55 ±3.42) × 109/L, respectively, compared with those of admission , they decreased gradually in the subsequent weekly examinations and had statistical significance ( t=3.204,2.777, 3.053,7.174,5.685,12.508, respectively;P<0.05).After 2 weeks of radiotherapy, the incidence of malnutrition increased compared to that of admission, and the scores of TSF, TP and TLC were 95.00%, 11.67% and 98.33% respectively, which showed the statistically significant difference (χ2 =11.800, 7.792, 73.024, respectively; P <0.05 ). Conclusions Patients with esophageal cancer gradually have higher risk of malnutrition and worse nutritional status during radiotherapy and their incidence of malnutrition increased after 2 weeks of radiotherapy .