摘要
目的应用全球(营养)领导人发起的营养不良(GLIM)诊断标准(共识),调查不同分期胃肠道恶性肿瘤患者营养不良患病率。方法整群采样调查2018年10月至2019年12月宁波市第一医院胃肠外科病区全部住院患者,符合胃癌、结直肠癌诊断的患者入组,采用NRS 2002筛查营养风险患病率,采用GLIM诊断标准的第二步(不包括全身肌肉量测定指标)诊断营养不良患病率,另保留2种营养不良评定方法(BMI<18.5 kg/m2伴一般情况差、营养风险筛查中营养缺失为3分)数据作为参比。结果2967例登记入数据库患者营养风险患病率为21.84%(648/2967),入组的529例胃肠道恶性肿瘤患者营养风险患病率为40.83%(216/529),其中胃癌患者营养风险患病率为41.79%(140/335)、结直肠癌患者营养风险患病率为39.18%(76/194)。应用GLIM诊断标准第二步(不包括全身肌肉量指标)诊断营养不良:胃癌患者营养不良患病率为15.22%(51/335)、结直肠癌患者营养不良患病率为12.37%(24/194);Ⅲ期胃癌、结直肠癌患者营养不良患病率分别为28.99%(49/169)、20.75%(22/106)。3个来源营养不良评定与诊断结果均显示,Ⅲ期胃癌、结直肠癌患者的营养不良患病率显著高于Ⅰ、Ⅱ期患者。结论胃肠道恶性肿瘤患者存在较高的营养风险。晚期胃肠道恶性肿瘤患者营养不良患病率较高。将评定营养不良数据作为参比,对于GLIM早期临床应用可能有一定意义。
Objective To investigate the prevalence of malnutrition in patients with different stages of gastrointestinal malignancies using GLIM diagnostic criteria(consensus).Methods Cluster sampling was performed among all inpatients in the gastrointestinal surgery department from October 2018 to December 2019 in Ningbo First Hospital.Patients diagnosed with gastric and colorectal cancer were enrolled and the nutritional risk and malnutrition prevalence were investigated.NRS 2002 was adopted to identify patients with nutritional risk and the 2-step GLIM criteria(systemic muscle mass measurements not included)were used to diagnose malnutrition.In the meantime,data obtained with another two assessment methods for malnutrition(BMI<18.5 kg/m2 with poor general physical condition and scored 3 for impaired nutritional status)were collected as reference.Results A total of 2967 patients were admitted to the gastrointestinal surgery department of Ningbo First Hospital from October 2018 to December 2019,among whom the prevalence of nutritional risk was 21.84%(648/2967).529 patients with gastrointestinal malignancies undergoing radical surgery were enrolled and 40.83%(216/529)were at nutritional risk.The prevalence of nutritional risk in gastric cancer patients was 41.79%(140/335)and 39.18%(76/194)in colorectal cancer patients.By the 2-step GLIM criteria(systemic muscle mass measurements not included),the prevalence of malnutrition was 15.22%(51/335)and 12.37%(24/194)in gastric and colorectal cancer patients,respectively.The prevalence of malnutrition in stageⅢgastric cancer and colorectal cancer patients was 28.99%(49/169)and 20.75%(22/106),respectively,higher than that in patients with stageⅡdiseases.Conclusions Patients with gastrointestinal malignancies are at high nutritional risk.The prevalence of malnutrition is higher in patients with advanced gastrointestinal malignancies.The use of two malnutrition assessment methods as reference may be of significance for the early clinical application of GLIM diagnosis criteria.
作者
李益萍
俞雅芬
谢浩芬
徐琴鸿
蔡泽君
杨斌
严志龙
Li Yiping;Yu Yafen;Xie Haofen;Xu Qinhong;Cai Zejun;Yang Bin;Yan Zhilong(Department of Surgery,Ningbo First Hospital,Ningbo 315010,China;Department of Nursing,Ningbo First Hospital,Ningbo 315010,China)
出处
《中华临床营养杂志》
CAS
CSCD
2020年第5期297-302,共6页
Chinese Journal of Clinical Nutrition
基金
中华医学会杂志社护理学科研究课题(CMAPH-NPI2019049)
宁波市第一医院院级护理课题(H2017PY004)。
关键词
营养风险筛查2002
营养风险
营养评定
营养不良诊断
胃肠道恶性肿瘤分期
患病率
Nutritional risk screening 2002
Nutritional risks
Nutritional assessment
Diagnosis of malnutrition
Gastrointestinal malignancies staging
Prevalence
