中国口腔颌面外科杂志

中国口腔颌面外科杂志 ›› 2023, Vol. 21 ›› Issue (6): 538-547.doi: 10.19438/j.cjoms.2023.06.002

• 论著 • 上一篇    下一篇

口腔癌患者营养状况变化轨迹及其影响因素分析

陈歆旖1, 李晨蕾1, 秦兴军2, 张金凤1   

  1. 1.上海交通大学医学院附属第九人民医院 护理部,上海 200011;
    2.上海交通大学医学院附属第九人民医院 口腔颌面-头颈肿瘤科,上海交通大学口腔医学院, 国家口腔医学中心,国家口腔疾病临床医学研究中心,上海市口腔医学重点实验室, 上海市口腔医学研究所,上海市头颈肿瘤诊治和转化医学中心,上海 200011
  • 收稿日期:2023-03-29 修回日期:2023-06-15 出版日期:2023-11-20 发布日期:2023-12-07
  • 通讯作者: 张金凤,E-mail: 723252@sh9hospital.org.cn
  • 作者简介:陈歆旖（1998-）,女,本科,E-mail: karen_chenxy@163.com
  • 基金资助:
    上海交通大学医学院附属第九人民医院护理院级基金(JYHL2021IMS30)

Factors influencing nutrition trajectories of patients with oral cancer

CHEN Xin-yi1, LI Chen-lei1, QIN Xing-jun2, ZHANG Jin-feng1   

  1. 1.Department of Nursing, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine. Shanghai 200011;
    2. Department of Oromaxillofacial Head and Neck Oncology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; College of Stomatology, Shanghai Jiao Tong University; National Center for Stomatology; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology; Shanghai Research Institute of Stomatology; Shanghai Center of Head and Neck Oncology Clinical and Translational Science. Shanghai 200011, China
  • Received:2023-03-29 Revised:2023-06-15 Online:2023-11-20 Published:2023-12-07

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摘要： 目的: 探讨口腔癌患者术前至术后3个月长期的营养状况变化轨迹及其影响因素,为临床干预提供依据。方法: 选择上海交通大学医学院附属第九人民医院北部口腔颌面-头颈肿瘤科住院治疗的口腔癌患者269例,采用一般资料调查表（一般人口学资料、肿瘤相关资料、人体测量指标、实验室指标）了解患者的基本情况,使用PG-SGA量表于患者术前、术后1个月、术后3个月进行营养状况评价。采用SPSS 26.0软件包对数据进行单因素和多因素分析。结果: 269例口腔癌患者中,持续营养良好11例（4.1%）、营养状况恶化23例（8.5%）、营养状况好差交替78例（29%）、营养状况好转111例（41.3%）、持续营养不良46例（17.1%）。多因素logistic回归分析发现,胃管保留时间延长（OR=0.955,P=0.001）、行皮瓣移植手术（OR=0.010,P=0.011）、术后放疗（OR=0.349,P=0.016）、上臂肌围减小（OR=1.669,P=0.007）、白蛋白水平低（OR=1.194,P=0.009）的患者,更有可能发生持续营养不良。结论: 口腔癌患者术前至术后3个月的营养状况问题严重,医护人员应关注营养不良高风险人群,并对其进行阶段性营养状况监测,及时采取一系列针对性营养治疗。

关键词: 口腔癌, 营养评价, 营养不良, 变化轨迹, 影响因素

Abstract: PURPOSE: To explore the long-term changes in nutritional status from preoperative to 3 months postoperatively in oral cancer patients, as well as the influencing factors, to provide guidance for clinical interventions. METHODS: A total of 269 patients with oral cancer admitted to the Northern Department of Oromaxillofacial Head and Neck Oncology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine were selected. General questionnaire (demographic data, tumor-related data, anthropometric indicators, laboratory indicators) was used to understand the basic information of the patients. Nutrition status(PG-SGA scale) was measured before treatment, 1 and 3 months after finishing treatment. The data was processed by SPSS 26.0 software package for univariate and multivariate analysis. RESULTS: Among the 269 patients, 11 cases (4.1%) had a persistent good nutrition, 23 cases (8.5%) had a worsening nutrition, 78 cases (29%) alternated between good and poor nutrition, 111 cases (41.3%) had an improving nutrition, and 46 cases (17.1%) had a persistent malnutrition. Multiple logistic regression showed that patients with prolonged gastric tube retention time (OR=0.955, P=0.001), flap transplantation (OR=0.010, P=0.011), postoperative radiotherapy (OR=0.349, P=0.016), reduced upper arm muscle circumference (OR=1.669, P=0.007), and low albumin levels (OR=1.194, P=0.009) were more likely to develop persistent malnutrition. CONCLUSIONS: Unfavorable nutrition trajectories are prevalent among patients with oral cancer from pre-treatment to 3-month after treatment. Periodic nutrition assessment starting shortly after diagnosis is necessary to identify persistent malnutrition, especially among high-risk group, in order to take a series of targeted nutritional treatment timely.

Key words: Oral cancer, Nutrition assessment, Malnutrition, Trajectory, Influencing factor

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