作者：徐岩1，杜芊芊2，罗凝香3，赖淑蓉4，陈裕明5，张美芬2

单位：1.中山大学附属第一医院南沙院区普外一科（胃肠），广东 广州 510000；2.中山大学护理学院，广东 广州 510000；3.中山大学附属第一医院外科护理教研室，广东 广州 510080；4.中山大学附属第一医院胃肠外科中心，广东 广州 510080；5.中山大学公共卫生学院，广东 广州 510000

Authors: Xu Yan1, Du Qianqian2, Luo Ningxiang3, Lai Shurong4, Chen Yuming5, Zhang Meifen2

Unit：1. General Surgery Unit 1, the Nansha Branch of the First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510000, Guangdong, Chian；2. School of Nursing, Sun Yat-sen University, Guangzhou 510000, Guangdong, China；3. The Department of Surgery Nursing, the First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, Guangdong, China；4. Department of Gastrointestinal Surgery, the First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, Guangdong, China；5. School of Public Health, Sun Yat-sen University, Guangzhou 510000, Guangdong, China

摘要：

目的  了解结直肠癌化疗患者治疗期间的膳食情况，并分析其膳食结构及相关影响因素，为医务人员制定针对性膳食食谱、膳食干预措施提供依据。方法  选取2021年9月至2022年3月178例在中山大学附属第一医院行化疗的结直肠癌患者作为研究对象。对患者的食物摄入情况、营养素摄入情况、膳食知信行情况进行调查分析，使用中国膳食宝塔（Chinese food pagoda, CHFP）评分法计算患者的膳食结构评分，并采用多因素Logistic回归分析探讨膳食结构评分的影响因素。结果  结直肠癌化疗患者的CHFP得分总分中位数为24.94 (21.78, 28.51)分，其中谷薯类、水果类、油的CHFP得分较高。结直肠癌化疗患者治疗期间每日能量及碳水化合物的实际摄入量低于推荐摄入量（P＜0.05）。多因素Logistic回归分析结果显示，消瘦（体重指数＜18.5 kg/m²）是膳食结构评分高的保护因素（OR=0.263，95%CI 0.078~0.885，P=0.031），而膳食营养知识得分高（OR=1.142，95%CI 1.017~1.283，P=0.025）、膳食营养行为得分高（OR=1.121，95%CI 1.014~1.240，P=0.026）则是膳食结构评分高的危险因素。结论  大多数结直肠癌化疗患者的膳食结构欠合理，主要营养素供能比不合理，膳食营养知识、膳食营养行为是其主要的影响因素。医务人员在临床中应重视膳食宣教与干预，提高结直肠癌化疗患者膳食结构的合理性。

关键词：结直肠癌；化疗；膳食结构；知信行 

Abstract：

Objective  To understand the dietary situation of colorectal cancer patients during chemotherapy and analyze their dietary structure and its influencing factors to provide a basis for medical staff to formulate targeted dietary recipes and dietary intervention measures. Method  A total of 178 colorectal cancer patients who received chemotherapy in the First Affiliated Hospital of Sun Yat-sen University from September 2021 to March 2022 were enrolled in the study. The food intake, nutrient intake, knowledge, belief and practice of food of patients were investigated and analyzed. Chinese food pagoda (CHFP) scoring method was used to score dietary structure of patients. Multivariate Logistic regression analysis was used to explore the influencing factors of dietary structure. Result  The median CHFP total score of colorectal cancer patients receiving chemotherapy was 24.94 (21.78, 28.51) points, among which the CHFP scores of cereals and potatoes, fruits and oils were higher. The daily actual intakes of energy and carbohydrate of colorectal cancer patients during chemotherapy were lower than recommended intakes (P＜0.05). The multivariate Logistic regression analysis showed that emaciation (body mass index＜18.5 kg/m²) was a protective factor for high CHFP score (OR=0.263, 95%CI 0.078-0.885, P=0.031), while high nutrition knowledge score (OR=1.142, 95%CI 1.017-1.283, P=0.025) and high nutrition behavior score (OR=1.121, 95%CI 1.014 -1.240, P=0.026) were risk factors for high CHFP score. Conclusion  The dietary structure of most colorectal cancer patients receiving chemotherapy is inappropriate, and the energy supply ratio of major nutrients is unreasonable. Dietary nutrition knowledge and behavior are the main influencing factors. Medical staff should pay attention to dietary education and intervention in clinical practice to improve the rationality of the dietary structure of colorectal cancer patients undergoing chemotherapy.

Key Words:  Colorectal cancer; Chemotherapy; Dietary structure; Knowledge, belief and practice

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