摘要
目的探讨个体化营养管理在成人初发急性髓系白血病(acute myeloid leukemia,AML)患者化疗中的营养状况、人体成分、疗效的改变,为其营养支持提供依据。方法选取2019年9月至2022年4月在滨州医学院附属医院确诊AML并使用标准诱导化疗方案的患者143例,通过NRS2002营养风险筛查,NRS2002评分≥3分的患者共95例,按照入院时间将其分为对照组(n=48)和研究组(n=47)。在化疗期间,对照组给予常规饮食护理,研究组根据患者个体营养状况给予个体化营养管理,比较干预前后两组患者的主观整体评估(patient-generated subjective global assessment,PG-SGA)状况、血液和人体成分中相关指标,比较干预后两组的化疗效果。结果干预后,研究组的PG-SGA评分低于对照组,差异有统计学意义(P<0.05)。研究组的血清总蛋白、白蛋白、血红蛋白、转铁蛋白、血小板最低值和中性粒细胞绝对值的水平均高于对照组,差异均有统计学意义(P<0.05)。研究组的体脂肪量、内脏脂肪面积、腰围均低于对照组,差异均有统计学意义(P<0.05);两组体质量指数、身体细胞量、骨矿物质含量、左上臂肌围、肌肉量的水平比较,差异无统计学意义(P>0.05)。干预后,两组化疗疗效比较,差异无统计学意义(P>0.05)。结论个体化营养管理能够有效提高AML患者的营养状况,降低营养不良的发生率,通过人体成分监测患者营养状况,为患者提供科学的营养指导,值得临床普及应用。
Objective To investigate the changes in nutritional status,body composition and efficacy of individualized nutrition management in adult patients with first-episode acute myeloid leukemia(AML)in chemotherapy,and to provide a basis for nutritional support.Methods A total of 143 patients diagnosed with AML and using standard induction chemotherapy regimens at the Affiliated Hospital of Binzhou Medical College from September 2019 to April 2022 were selected,and a total of 95 patients with NRS2002 scores≥3 by NRS2002 nutritional risk screening were divided into the control group(n=48)and the study group(n=47)according to the time of admission.During chemotherapy,the control group was given conventional dietary care,while the study group was given individualized nutritional management according to the patients'individual nutritional status.The patient-generated subjective global assessment(PG-SGA)status,blood and body composition related indicators of the two groups were compared before and after the intervention,and the chemotherapy effects of the two groups were compared.Results The score of PG-SGA after individualized nutrition guidance in the study group was lower than that in the control group,and the difference was statistically significant(P<0.05).The levels of total protein,albumin,hemoglobin,transferrin,platelet nadir and absolute neutrophil levels in the study group were higher than those in the control group,and the differences were statistically significant(P<0.05).The levels of body fat mass,visceral fat area and waist circumference in the study group were lower than those in the control group,and the differences were statistically significant(P<0.05).There was no statistically significant difference in body mass index, body cell mass, bone mineral content, left upper arm muscle circumference, and lean body mass compared with the control group (P>0.05). After nutritional intervention, there were more complete remissions in the study group than in the control group, there were fewer patients with partial
作者
付敏
张颖
任兴华
冯秀香
张敏
贾灵芝
FU Min;ZHANG Ying;REN Xinghua;FENG Xiuxiang;ZHANG Min;JIA Lingzhi(Department of Clinical Nutrition,Binzhou Medical University Hospital,Binzhou 256603,Shandong,China;Department of Hematology,Binzhou Medical University Hospital,Binzhou 256603,Shandong,China;Department of Nursing,Binzhou Medical University Hospital,Binzhou 256603,Shandong,China)
出处
《中国现代医生》
2023年第8期1-4,14,共5页
China Modern Doctor
基金
山东省医药卫生科技发展计划项目(2017WS362)
滨州医学院附属医院护理部课题(BYFYHL-201903)。
关键词
人体成分
急性髓系白血病
营养管理
Body composition
Acute myeloid leukemia
Nutritional management
