内科

目的探讨食管癌住院治疗患者的营养状况及其影响因素。方法选取200例食管癌住院治疗患者作为研究对象，应用患者主观整体营养评估量表（PG-SGA）对患者的营养状态进行评估，并根据评估结果将患者分为营养良好组、轻中度营养不良组、重度营养不良组。比较3组患者的性别、年龄、病程、肿瘤部位、原发肿瘤-区域淋巴结-远处转移（TNM)分期、肿瘤负荷、接受手术治疗、不良饮食行为等情况。对食管癌住院治疗患者发生营养不良的影响因素进行单因素分析和多因素logistic回归分析。结果200例食管癌住院治疗患者中，营养不良患者129例，营养不良发生率为64.50%［其中轻中度营养不良患者81例（62.79%）、重度营养不良患者48例（37.21%）］。单因素分析结果显示，3组患者的性别、肿瘤部位、TNM分期、肿瘤负荷情况、不良饮食行为、照护者具备一定营养学知识情况比较，差异均无统计学意义（均P＞0.05）；3组患者的年龄、病程、接受手术治疗情况、吞咽功能障碍情况、给予营养干预情况、护患关系、照护者严格遵医嘱情况比较，差异均有统计学意义（均P＜0.05）。多因素logistic回归分析结果显示，病程、吞咽功能障碍、给予营养干预情况、护患关系、照护者严格遵医嘱情况均是食管癌患者发生营养不良的独立影响因素（均P＜0.05）。结论很大部分食管癌住院患者的营养状况不佳，病程、吞咽功能障碍、给予营养干预情况、护患关系、照护者严格遵医嘱情况是食管癌患者发生营养不良的独立影响因素。

ObjectiveTo investigate the nutritional status of hospitalized patients with esophageal cancer and its influencing factors. MethodsA total of 200 hospitalized patients with esophageal cancer were selected as the research subjects, and their nutritional statuses were evaluated by the Patient-Generated Subjective Global Assessment (PG-SGA). According to the evaluation results, the patients were divided into a well-nourished group, a mild-to-moderate malnutrition group, or a severe malnutrition group. The gender, age, course of disease, tumor location, tumor-node-metastasis (TNM) stage, tumor burden, surgical treatment, and poor dietary behaviors were compared among the three groups. Univariate analysis and multivariate logistic regression analysis were performed to find the influencing factors of malnutrition in hospitalized patients with esophageal cancer. ResultsAmong the 200 hospitalized patients with esophageal cancer, 129 patients had malnutrition, and the incidence of malnutrition was 64.50% (including 81 patients with mild to moderate malnutrition ［62.79%］ and 48 patients with severe malnutrition ［37.21%］). The results of univariate analysis showed that there was no statistically significant difference in gender, tumor location, TNM stage, tumor burden, poor dietary behaviors, or caregivers′ certain nutrition knowledge among the three groups of patients (all P＞0.05). There were statistically significant differences in age, course of disease, surgical treatment, swallowing dysfunction, nutritional intervention, nurse-patient relationship, and strict compliance with doctors′ orders by caregivers in the three groups (all P＜0.05). The results of multivariate logistic regression analysis showed that course of disease, swallowing dysfunction, nutritional intervention, nurse-patient relationship, and strict compliance with doctors′ orders by caregivers were independent influencing factors of malnutrition in patients with esophageal cancer (all P＜0.05). ConclusionMostly hospitalized patients with esophageal cancer have poor nutritional status. Course of disease, swallowing dysfunction, nutritional intervention, nurse-patient relationship, and strict compliance with doctors′ orders by caregivers are independent influencing factors of malnutrition in patients with esophageal cancer.