摘要
目的了解乳腺癌术后化疗患者发生营养不良的临床现状和风险因素,并构建其风险评分系统。方法回顾性收集297例乳腺癌术后化疗患者的病例资料,采用单因素分析和Logistic回归分析对各风险因素进行分析,构建其评分系统,采用HosmerLemeshowχ2检验和ROC曲线下面积对评分系统进行评价。结果共101例(34.0%)患者发生营养不良,疼痛情况、肝功能损害、口腔黏膜炎、腹胀、年龄、化疗药物相对剂量强度、消化道反应、辅助放疗、便秘和镇痛药是乳腺癌术后化疗患者发生营养不良的10项风险因素(P<0.05,P<0.01)。构建的风险评分系统得分为0～47分,Hosmer-Lemeshow χ~2=3.986,P=0.503;ROC曲线下面积为0.908,评分达到29分时,敏感度和特异度分别为90.2%和80.4%,约登指数最大(0.706)。结论乳腺癌术后化疗患者发生营养不良的比例较高,构建的风险评分系统具有较高的预测能力和判别能力,可作为乳腺癌术后化疗患者的营养风险筛查工具。
Objective To understand the clinical status and risk factors of malnutrition in breast cancer patients receiving postoperative chemotherapy,and to construct a risk scoring system.Methods Clinical data of297breast cancer patients receiving postoperative chemotherapy were collected retrospectively.Then univariate analysis and logistic regression analysis were utilized to analyze the risk factors and construct the scoring system,and the Hosmer-Lemeshow chi square test and the area under ROC curve were used to evaluate the scoring system.Results Totally101(34%)patients suffered malnutrition,and10risk factors of malnutrition in breast cancer patients receiving postoperative chemotherapy were identified,which were pain,liver function damage,oral mucositis,abdominal distension,age,relative dose intensity of chemotherapy drugs,digestive tract reaction,adjuvant radiotherapy,constipation and analgesics(P<0.05,P<0.01).The total score of the risk scoring system was0-47,Hosmer-Lemeshow fitting testχ^2was3.986,P was0.503,the area under ROC curve was0.908,and when the total score was29,the sensitivity and specificity of the system was90.2%and80.4%,and the maximum Youden index was obtained,which was0.706.Conclusion The proportion of malnutrition in breast cancer patients receiving postoperative chemotherapy is relatively high,and the risk scoring system has good predicting and discriminating ability,which can be used as a nutrition risk screening tool for breast cancer patients receiving postoperative chemotherapy.
作者
孙晓文
张文莹
李军涛
Sun Xiaowen;Zhang Wenying;Li Juntao(Galactophore Department, Affiliated Cancer Hospital of Zhengzhou University (Henan Tumor Hospital), Zhengzhou 450008, China)
出处
《护理学杂志》
CSCD
北大核心
2018年第23期1-4,共4页
Journal of Nursing Science
基金
2017年度河南省医学科技攻关计划项目(201702250)
关键词
乳腺肿瘤
营养不良
风险因素
预测评分系统
营养管理
breast neoplasms
malnutrition
risk factors
prediction scoring system
nutrition management
