头颈部恶性肿瘤患者放射治疗期间骨骼肌量变化及其影响因素分析

doi:10.3969/j.issn.1672-1756.2020.03.006

中国护理管理 ›› 2020, Vol. 20 ›› Issue (3): 338-343.doi: 10.3969/j.issn.1672-1756.2020.03.006

• 特别策划·临床营养管理 • 上一篇下一篇

头颈部恶性肿瘤患者放射治疗期间骨骼肌量变化及其影响因素分析

路潜张彤张力川王玉洁庄冰金三丽李红梅龚丽青王艳莉方玉肖绍文郑宝敏孙艳

北京大学护理学院，100191 北京市（路潜，张彤，张力川，王玉洁，庄冰，金三丽）；山西省中西医结合医院胸普外科（李红梅）；北京大学肿瘤医院营养科（龚丽青，王艳莉，方玉）；放射治疗科（肖绍文，郑宝敏，孙艳）

出版日期:2020-03-15 发布日期:2020-03-15
作者简介:路潜，博士，教授，博士生导师，E-mail:luqian@bjmu.edu.cn

The change of skeletal muscle mass and its influencing factors in Head and Neck Cancer patients treated with radiotherapy

LU Qian, ZHANG Tong, ZHANG Lichuan, WANG Yujie, ZHUANG Bing, JIN Sanli, LI Hongmei, GONG Liqing, WANG Yanli, FANG Yu, XIAO Shaowen, ZHENG Baomin, SUN Yan

Peking University School of Nursing, Beijing, 100191, China

Online:2020-03-15 Published:2020-03-15

摘要/Abstract

摘要： 目的：观察头颈部恶性肿瘤患者放射治疗期间骨骼肌量的变化，并分析其影响因素。方法：采用便利取样方法，选取2017年3月至2019年9月在北京市某专科肿瘤医院放射治疗科接受放射治疗的头颈部恶性肿瘤患者为研究对象，应用患者参与主观全面评定（Patient Generated Subjective Global Assessment，PG-SGA）的症状部分评估患者在放疗开始前（T1）、放疗中期（T2）、放疗结束时（T3）的营养相关症状（Nutrition Impact Symptoms，NIS），用24h膳食回顾法记录膳食摄入情况并采用生物电阻抗分析法测定骨骼肌量变化情况，采用广义估计方程（Generalized Estimating Equations，GEE）分析患者骨骼肌量变化的影响因素。结果：共459例患者完成3次测评。在3个测评时间点，骨骼肌量分别为（26.31±5.08）kg、（25.60±4.83）kg、（24.62±4.68）kg；NIS发生率分别为38.1%（175/459）、93.2%（428/459）、95.4%（438/459）；标准化每日能量摄入量（standard Daily Energy Intake，stDEI)分别为（24.94±8.51）kcal/（kg·day）、（20.47±9.14）kcal/（kg·day）、（18.23±9.75）kcal/（kg·day），标准化每日蛋白摄入量（standard Daily Protein Intake，stDPI)分别为（0.98±0.39）g/（kg·day）、（0.86±0.39）g/（kg·day）、（0.84±0.51）g/（kg·day）；随放射治疗的进行，患者骨骼肌量逐渐下降、NIS得分逐渐增加、能量及蛋白质摄入逐渐减少。骨骼肌量变化与放疗前是否手术、膳食能量摄入量及NIS得分密切相关。结论：头颈部恶性肿瘤放射治疗患者治疗后骨骼肌量减少，放疗前未手术、膳食能量摄入不足及NIS重的患者骨骼肌量减少多。提示应重视未手术患者，加强营养相关症状管理和膳食干预，以减轻患者骨骼肌量的丢失。

关键词: 头颈部恶性肿瘤；放射治疗；营养相关症状；膳食摄入；骨骼肌

Abstract: Objective: To observe the change of skeletal muscle mass in patients with Head and Neck Cancer during radiotherapy and analyze its influencing factors. Methods: Patients with Head and Neck Cancer treated with radiotherapy in a cancer hospital in Beijing from March 2017 to September 2019 were recruited. The symptom section of Patient Generated Subjective Global Assessment (PG-SGA) was used to assess the Nutrition Impact Symptoms (NIS) of patients before (T1), during (T2) and at the end (T3) of the radiotherapy. Dietary intake was recorded by 24-hour dietary recall and skeletal muscle mass were measured by bioelectrical impedance analysis. Generalized Estimating Equations (GEE) were used to analyze the influencing factors of skeletal muscle mass of head and neck cancer patients during radiotherapy. Results: Totally 459 patients were completely investigated. At the three evaluation time points, the skeletal muscle mass was (26.31±5.08) kg, (25.60±4.83) kg, (24.62±4.68) kg respectively; the incidence of NIS was 38.1% (175/459), 93.2% (428/459), 95.4% (438/459) respectively; standard daily energy intake (stDEI) was (24.94±8.51) kcal/(kg·day), (20.47±9.14) kcal/(kg·day), (18.23±9.75) kcal/(kg·day) respectively, and standard daily protein intake (stDPI) was (0.98±0.39) g/(kg·day), (0.86±0.39) g/(kg·day), (0.84±0.51) g/(kg·day) respectively. With the progress of radiotherapy, the patient's skeletal muscle mass gradually decreased, NIS increased, and energy and protein intake declined. Changes in skeletal muscle mass of patients were closely related to whether they had undergone surgery before radiotherapy, dietary energy intake and NIS scores. Conclusion: Patients with radiation therapy have reduced skeletal muscle mass after treatment, and patients with non-surgical, insufficient dietary energy intake and NIS have a greater reduction in skeletal muscle mass. It is suggested that attention should be paid more to non-surgical patients, and nutrition-related symptoms management and dietary intervention should be strengthened to reduce the loss of skeletal muscle mass.

Key words: Head and Neck Cancer; radio therapy; nutrition impact symptoms; dietary intake; skeletal muscle

中图分类号:

路潜张彤张力川王玉洁庄冰金三丽李红梅龚丽青王艳莉方玉肖绍文郑宝敏孙艳. 头颈部恶性肿瘤患者放射治疗期间骨骼肌量变化及其影响因素分析[J]. 中国护理管理, 2020, 20(3): 338-343.

LU Qian, ZHANG Tong, ZHANG Lichuan, WANG Yujie, ZHUANG Bing, JIN Sanli, LI Hongmei, GONG Liqing, WANG Yanli, FANG Yu, XIAO Shaowen, ZHENG Baomin, SUN Yan. The change of skeletal muscle mass and its influencing factors in Head and Neck Cancer patients treated with radiotherapy[J]. Chinese Nursing Management, 2020, 20(3): 338-343.

[1]	刘珍张艳董树美周树红赵敬李宏洁杜灿灿田雨同. 远程健康照护准备度量表的汉化及信度效度检验[J]. 中国护理管理, 2020, 20(8): 1154-1158.
[2]	张楠韩月皎苏莉莉王亚菲王妍刘峰. 儿童肠造口延续性护理现状及研究进展[J]. 中国护理管理, 2020, 20(8): 1183-1187.
[3]	王娴张瑞丽温鹏天李慧娟吴景梅. 基于Andersen行为模型的社区老年人使用日间照料中心的影响因素分析[J]. 中国护理管理, 2020, 20(8): 1187-1191.
[4]	刘莹张懿周裕婧. 养老机构护士灵性照顾能力及其影响因素分析[J]. 中国护理管理, 2020, 20(8): 1220-1224.
[5]	祝红梅江华卢言慧张光鹏李明子. 北京市6所三级医院高年资护士职业高原现状及影响因素分析[J]. 中国护理管理, 2020, 20(8): 1204-1210.
[6]	冯月李俊英. PICC相关性静脉血栓风险评估工具在肿瘤患者中应用的有效性研究[J]. 中国护理管理, 2020, 20(8): 1258-1262.
[7]	徐忠梅刘芳常芸陈玉红沈莹吴娟. 心血管专科护士创新行为现状及其与信息素养的关系[J]. 中国护理管理, 2020, 20(8): 1211-1215.
[8]	耿玉芳周利华王维利. 文化智力影响临床护士整合-冲突处理模式的中介效应分析[J]. 中国护理管理, 2020, 20(8): 1215-1219.
[9]	张会敏高杰孙羽燕张楠张俊蕾唐四元. 某精神病院精神科护士人文关怀能力现状及其影响因素分析[J]. 中国护理管理, 2020, 20(8): 1224-1227.
[10]	孙雪莲高文慧李思颉陈婷梁潇. 工作实录分析联合情景模拟演练在突发群体伤救护中的应用效果[J]. 中国护理管理, 2020, 20(8): 1228-1231.
[11]	姚秀钰程艮杨磊. 我国男护士执业现状和职业认知的调查分析[J]. 中国护理管理, 2020, 20(8): 1232-1235.
[12]	郭桂丽韩斌如董婷婷. SSKIN集束化护理措施对院内压力性损伤预防效果的研究[J]. 中国护理管理, 2020, 20(8): 1241-1244.
[13]	王煜马洪升戴燕唐孟言刘洋. 日间手术患者对围术期管理移动医疗手机应用软件需求的调查分析[J]. 中国护理管理, 2020, 20(8): 1236-1241.
[14]	赵礼婷郭金玉韩玮芬田丽莎王泠. 发展性反馈管理在预防急诊抢救区患者院内压力性损伤中的应用效果[J]. 中国护理管理, 2020, 20(8): 1245-1248.
[15]	乐霄刘于柯键于明峰张文艳. 儿童患者呼吸道护理诊断精确性临床指征研究进展[J]. 中国护理管理, 2020, 20(8): 1249-1253.

头颈部恶性肿瘤患者放射治疗期间骨骼肌量变化及其影响因素分析

The change of skeletal muscle mass and its influencing factors in Head and Neck Cancer patients treated with radiotherapy

PDF (PC)

赞

可视化

摘要/Abstract

引用本文

使用本文

参考文献

相关文章 15

Metrics

本文评价

推荐阅读 10