CAJ | 학술논문

目的：探讨化疗对消化系统肿瘤患者营养状态变化的影响。方法141例消化系统肿瘤患者分别按性别分组(男性组和女性组)、年龄段分组(青年组、中年组和老年组)、疾病分期分组(Ⅱ期、Ⅲ期、Ⅳ期)，通过人体测量法和实验室检测法监测患者化疗前1天及4周期化疗结束后1天的肱三头肌皮褶厚度(TSF)、理想体质量百分比(BW%)、体质量指数(BMI)、血红蛋白(HGB)、血清白蛋白(ALB)、前白蛋白(PA)及淋巴细胞总数(TLC)，用简易营养评定法来综合评价消化系统肿瘤患者化疗前后的营养状况。结果不同性别患者在化疗前、后营养不良发生率差异无统计学意义(P >0.05)；随着年龄增长化疗后营养不良发生率明显增高(P <0.05)；随分期的增高营养不良发生率明显增高(P <0.05)。结论①TSF 和 TLC 是相对较敏感指标，可以作为患者化疗前后营养不良评价指标；②化疗毒性对性别无选择性；③老年患者及病期较晚的患者对化疗的耐受性差，较中、青年患者及早期患者更易发生营养不良；④用 TSF 法评定为营养不良患者与 ALB、PA 及 TLC 评价结果的符合率较高，而与 HGB 评价结果符合率相对较低。
목적：탐토화료대소화계통종류환자영양상태변화적영향。방법141례소화계통종류환자분별안성별분조(남성조화녀성조)、년령단분조(청년조、중년조화노년조)、질병분기분조(Ⅱ기、Ⅲ기、Ⅳ기)，통과인체측량법화실험실검측법감측환자화료전1천급4주기화료결속후1천적굉삼두기피습후도(TSF)、이상체질량백분비(BW%)、체질량지수(BMI)、혈홍단백(HGB)、혈청백단백(ALB)、전백단백(PA)급림파세포총수(TLC)，용간역영양평정법래종합평개소화계통종류환자화료전후적영양상황。결과불동성별환자재화료전、후영양불량발생솔차이무통계학의의(P >0.05)；수착년령증장화료후영양불량발생솔명현증고(P <0.05)；수분기적증고영양불량발생솔명현증고(P <0.05)。결론①TSF 화 TLC 시상대교민감지표，가이작위환자화료전후영양불량평개지표；②화료독성대성별무선택성；③노년환자급병기교만적환자대화료적내수성차，교중、청년환자급조기환자경역발생영양불량；④용 TSF 법평정위영양불량환자여 ALB、PA 급 TLC 평개결과적부합솔교고，이여 HGB 평개결과부합솔상대교저。
Objective To explore the change in nutritional status pre-and post-chemotherapy on the digestive system carcinoma patients.Methods The data of 1 14 cases with digestive cancer were divided into two groups by gender,by age into three groups,young group,middle age group and elderly group,by disease stage into Ⅱ stage,Ⅲstage and Ⅳ stage group.Through anthropometric method and laboratory tests,the patients were monitored in triceps skinfold (TSF),ideal body mass (BW%),body mass index (BMI),hemoglobin (HGB),serum albumin (ALB), prealbumin (PA)and total lymphocyte count (TLC)pre-and post-chemotherapy with simple nutritional evaluation in different gender,different age groups and different disease stage groups.Results The gender showed no statistic significance in malnutrition rates (P > 0.05 ),with age increase,the malnutrition rates raised significantly after chemotherapy (P < 0.05 ). And with disease stage increase,the malnutrition rates raised significantly after chemotherapy(P <0.05).Conclusion ①TSF and TLC are relatively sensitive indexes in patients with malnutrition pre-and post-chemotherapy;②Chemotherapy toxicity showed no choice in gender for incidence of malnutrition pre-and post-chemotherapy ;③ The tolerance to chemotherapy was poor in elderly patients and the patients with advanced cancer were more likely malnourished than early or youth cases;④ TSF assessment for patients with malnutrition showed higher coincidence rate with ALB,PA and TLC,but,its coincidence rate with HGB evaluation is relatively low.