作者：黄稳达，杨家君，黄学军，邓俊晖

单位：惠州市中心人民医院 肛肠外科，广东 惠州516001

Authors:  HUANG Wenda, YANG Jiajun, HUANG Xuejun, DENG

Jun-hui

Unit: Department of colorectal cancer, Huizhou Municipal Central Hospital, Huizhou 516001, Guangdong, China

摘要：

目的  利用NRS 2002分析常见恶性肿瘤的营养状况。方法  2016年12月至2018年4月在惠州市中心人民医院住院的常见恶性肿瘤患者,均有病理结果诊断明确,均自愿入选本研究。按照入院目的分为放化疗组和手术治疗组、并发症治疗组。所有患者入院24 h内,由经过正规培训的同1名外科医师采用统一询问方式,对符合条件的调查对象分别应用NRS 2002进行营养风险评估。所有患者均于入院后第二天清晨空腹抽取静脉血,测定血清白蛋白。NRS 2002评分≥3诊断为存在营养风险,分析常见恶性肿瘤患者的营养状况。结果  (1)所有参与研究的482例患者中,经NRS 2002评分≥3分的有242例,为50.2%;存在营养风险患者的年龄高于无营养风险患者。(2)手术治疗组和并发症治疗组患者的营养风险发生率较放化疗治疗组高。(3)放化疗组中存在营养风险和无营养风险者的住院时间和住院费用差异统计学意义(P <0.05),手术组和并发症治疗组人群中的存在营养风险组和无营养风险组的差异无统计学意义。(4)荷瘤组营养风险的发生率高于无瘤组营养风险的发生率(P <0.001),肿瘤分期越晚,营养风险发生率越高。结论  (1)NRS 2002可以较好地反映常见恶性肿瘤患者的营养状态,而且能够预测放化疗患者的住院时间及费用;(2)荷瘤患者的营养风险发生率较高(55.4%),尤其应重视老年人、恶性肿瘤晚期患者的营养问题。

关键词： NRS 2002; 恶性肿瘤; 营养筛查

Abstract：

Objective  To evaluate the use of the nutritional risk screening 2002 (NRS 2002) for the assessment of nutritional status in patients with cancer. Methods  Patients hospitalized in Huizhou Municipal Central Hospital from December 2016 to April 2018 were enrolled. The diagnosis with tumors was confirmed by pathological examination and patients received chemotherapy/ radiotherapy or surgery or treatment for complication. The patients were interviewed by a trained surgeon using NRS 2002 within 24 hours after admission. The score ≥3 indicated nutritional risk. Results  482 patients participated in this study, 50.2% of the patients had score ≥3, the patients with nutritional risk were older than patients without nutritional risk. The incidence of nutritional risk in surgery group and treatment for complication group were higher than chemotherapy/ radiotherapy group. In the chemotherapy/ radiotherapy group, the length of hospital stay and hospital cost differences between patients with and without nutritional risk were statistically significant (p<0.05). The incidence of nutritional risk in patients bearing tumor is higher than those who not. Nutritional risk increased with higher TNM pathological stage. Conclusions  NRS 2002 is an appreciated tool for nutritional assessment for patients with tumors. It can predict the length of hospital stay and the hospitalization costs for the patients of chemotherapy/ radiotherapy. The patients bearing tumor have a high incidence of nutritional risk(55.4%). Special attentions should be taken to the old or high TNM pathological stage patients with cancer.

Key Words:  NRS 2002; Malignancy; Nutrition Screening