摘要
目的:分析直肠癌病人放化疗期间应用膳食管理APP开展全程营养管理的效果。方法:采用非随机对照研究,选择2017年6月至2018年11月收治的66例直肠癌病人为对照组,2020年5月至2021年4月收治的62例病人为干预组。两组每周一均采用NRS 2002及PG-SGA评分评估营养状况及放化疗反应,对照组根据病人营养状况进行个体化营养宣教,干预组根据营养评估结果设置能量及蛋白质目标量,每周连续3天通过膳食管理APP记录24 h饮食摄入,针对饮食摄入情况进行个性化营养宣教和干预,连续48 h不达标进行营养干预。比较两组病人在治疗期间NRS 2002评分、PG-SGA评分、BMI、总蛋白、白蛋白、前白蛋白、血红蛋白及放化疗毒性反应。结果:62例干预组病人总共记录930 d,能量及蛋白质均达标为550 d(68.41%)。两组在治疗结束时放化疗毒性反应,其中放射性肠炎、骨髓抑制及治疗耐受性具有统计学意义(P<0.05)。两组在治疗不同阶段PG-SGA评分、BMI、白蛋白及总蛋白的变化有统计学意义(P<0.05)。结论:采用膳食管理APP可精确记录病人饮食摄入,促进病人自我管理,开展个性化的营养指导与干预,有助于改善病人营养状况及提高放化疗耐受性。
Objective:To analyze the effects of dietary management APP for whole-course nutrition management in patients with rectal cancer during radiotherapy and chemotherapy.Methods:The non-randomized controlled study was divided into two groups.Sixty-six patients with rectal cancer were enrolled as the control group from June 2017 to November 2018,and 62 patients were enrolled as the intervention group from May 2020 to April 2021.Nurses evaluated patient’s nutritional status by NRS 2002 and PG-SGA and the response of radiotherapy and chemotherapy on each Monday.The patients in the control group received individualized nutrition consultation according to the nutritional status.The patients in the intervention group set the target of energy and protein according to the results of nutritional evaluation and needed to record the 24-hour dietary intake three days a week so that medical professionals could conduct personalized nutrition consultation and intervention.Nutritional interventions would be performed for those who fail to meet the target for 48 consecutive hours.The NRS 2002 score,PG-SGA score,BMI,total protein,albumin,prealbumin,hemoglobin,radiotherapy and chemotherapy toxicity were compared between the two groups during treatment.Results:The 62 patients in the intervention group recorded 930 days totally.There were 550 days(68.41%)days to reach nutritional goals.At the end of treatment,there were significant differences in radiation enteritis,bone marrow suppression and treatment tolerance between the two groups(P<0.05).There were significant differences in PG-SGA score,BMI,albumin and total protein at different period of treatment(P<0.05).Conclusion:The dietary management APP can record the patient’s dietary intake accurately and promote the self-management.Medical staff can carry out personalized nutritional consultation and intervention by APP.That may improve the patient’s nutritional status and alleviate treatment response furthermore.
作者
朱晓丹
谢茗珠
刘寒雪
ZHU Xiao-dan;XIE Ming-zhu;LIU Han-xue(Department of Nursing,Fudan University Shanghai Cancer Centers;Department of Oncology,Shanghai Medical College,Fudan University,200032 Shanghai,China)
出处
《肠外与肠内营养》
CAS
CSCD
北大核心
2021年第6期352-356,361,共6页
Parenteral & Enteral Nutrition
基金
复旦大学附属肿瘤医院院级基金(HL201603)。
关键词
直肠癌
新辅助治疗
营养管理
移动APP
Rectal cancer
Neoadjuvant therapy
Nutrition management
Mobile phone APP
