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目的研究集束化营养干预模式对鼻咽癌调强适形放射治疗(放疗)患者的影响,探讨有效可行的营养管理方法。方法选择2013年6月-2014年12月入住放疗科行调强适形放疗的鼻咽癌患者83例,通过随机数表法分为干预组(42例)及对照组(41例)。干预组采用营养风险筛查2002(NRS-2002)营养筛查、营养评估、实施个体化的全程营养干预模式,对照组实施常规健康教育与营养指导,观察并记录两组患者干预前后的营养风险、营养状态及放疗副反应情况,进行比较与评价。结果干预后,干预组NRS-2002评分显著低于对照组(P<0.05),体质量、体质量指数、三头肌皮褶厚度、上臂围和上臂肌围与对照组比较差异均有统计学意义(P<0.05),血清总蛋白、血清白蛋白、血清运铁蛋白均优于对照组(P<0.05),Ⅲ~Ⅳ级放射性口腔黏膜炎发生率低于对照组(P<0.05)。结论集束化营养干预模式能有效改善鼻咽癌调强适形放疗患者营养状况,降低营养不良风险,减轻放疗不良反应,促进肿瘤康复。
Objective To study the effect of cluster nutritional intervention on patients with nasopharyngeal carcinoma (CRT) undergoing conformal radiotherapy (radiotherapy) and to explore effective and feasible nutrition management methods. Methods Eighty-three patients with nasopharyngeal carcinoma undergoing conformal radiotherapy for radiotherapy from June 2013 to December 2014 were divided into intervention group (n = 42) and control group (n = 41) by random number table. The intervention group adopted nutrition risk screening 2002 (NRS-2002) nutrition screening, nutritional assessment and individualized whole nutrition intervention mode. The control group underwent routine health education and nutrition guidance, and observed and recorded nutritional risk before and after intervention , Nutritional status and radiotherapy side effects, for comparison and evaluation. Results After intervention, the score of NRS-2002 in the intervention group was significantly lower than that of the control group (P <0.05). There was significant difference in body mass, body mass index, trichoderma skin fold thickness, upper arm circumference and upper arm muscle circumference compared with the control group (P <0.05). Serum total protein, serum albumin and serum transferrin were superior to those of the control group (P <0.05). The incidence of grade Ⅲ ~ Ⅳ radiation oral mucositis was lower than that of the control group (P <0.05). Conclusion The cluster nutritional intervention model can effectively improve the nutritional status of patients with nasopharyngeal carcinoma in intensity modulated conformal radiotherapy, reduce the risk of malnutrition, reduce adverse reactions of radiotherapy and promote tumor rehabilitation.