标题：基于循证理论的营养管理在宫颈癌放疗患者中的应用

      作者：宋方方，祝宾华，王朝霞，李俊灵，顾浩    郑州大学第一附属医院放疗科，河南 郑州 450052

      卷次： 2024年35卷10期

      【摘要】 目的 探讨基于循证理论的营养管理在宫颈癌放疗患者中的应用效果。方法 选取2021年1月至2023年4月于郑州大学第一附属医院就诊的134例宫颈癌放疗患者纳入研究，按随机数表法分为循证营养组和常规组各67例。放疗期间，常规组患者给予常规的护理干预，循证营养组患者在常规护理的基础上给予基于循证理论的营养管理。放疗结束后(干预后)比较两组患者的营养状态[转铁蛋白(TRF)、白蛋白(ALB)、血红蛋白(Hb)]、心理状态[焦虑自评量表(SAS)、抑郁自评量表(SDS)]和生存质量[生活质量测定核心量表(QLQ-C30)]，同时比较两组患者干预期间的不良反应及放疗耐受性。结果 干预后，循证营养组患者的血清 TRF、ALB、Hb水平分别为(2.07±0.14) g/L、(33.79±1.03) g/L、(119.25±1.14) g/L，明显高于常规组的(1.78±0.11) g/L、(28.63±0.94) g/L、(103.71±1.09) g/L，差异均有统计学意义(P<0.05)；干预后，循证营养组患者的 SAS评分、SDS评分分别为(47.21±1.49)分、(45.85±2.28)分，明显低于常规组的(59.85±5.33)分、(54.36±3.15)分，差异均有统计学意义(P<0.05)；干预后，循证营养组患者的躯体、社会、认知、情绪功能评分分别为(90.15±1.05)分、(70.35±3.51)分、(92.03±1.43)分、(87.42±3.35)分，明显高于常规组的(85.42±1.01)分、(64.89±2.86)分、(87.14±1.27)分、(78.14±2.52)分，差异均有统计学意义(P<0.05)；循证营养组患者的骨髓抑制、急性放射性直肠炎、急性胃肠道反应发生率分别为70.15%、52.24%、76.12%，明显低于常规组的85.07%、73.13%、89.55%，差异均有统计学意义(P<0.05)；循证营养组患者放疗中断率为0，明显低于常规组的8.96%，差异有统计学意义(P<0.05)。结论 基于循证理论的营养管理可改善宫颈癌放疗患者的营养状态，调节其情绪状态，提升其放疗耐受性，降低不良反应的发生率，从而提高生存质量。
      【关键词】 宫颈癌；循证理论；营养管理；放疗；营养状态；生存质量
      【中图分类号】 R737.33 【文献标识码】 A 【文章编号】 1003—6350（2024）10—1494—05

Application of evidence-based nutritional management in patients with cervical cancer undergoing radiotherapy.SONG Fang-fang, ZHU Bin-hua, WANG Chao-xia, LI Jun-ling, GU Hao.
Department of Radiotherapy, the First AffiliatedHospital of Zhengzhou University, Zhengzhou 450052, Henan, CHINA
【Abstract】 Objective To explore the application effect of evidence-based nutrition management in patientswith cervical cancer undergoing radiotherapy. Methods A total of 134 patients with cervical cancer undergoing radio-therapy who were admitted to the First Affiliated Hospital of Zhengzhou University from January 2021 to April 2023were selected and randomly divided into evidence-based nutrition group and routine group by random number tablemethod, with 67 cases in each group. During radiotherapy, the routine group was given routine nursing intervention, andthe evidence-based nutrition group was given evidence-based nutrition management on the basis of routine nursing. Af-ter the end of radiotherapy (after intervention), the nutritional status [transferrin (TRF), serum albumin (ALB), hemoglo-bin (Hb)], psychological status [Self-rating Anxiety Scale (SAS), Self-rating Depression Scale (SDS)], quality of life[quality of life questionnaire core 30 (QLQ-C30)] were compared between the two groups. At the same time, the adversereactions and radiotherapy tolerance during intervention were compared between the two groups. Results After inter-vention, the serum levels of TRF, ALB, and Hb in the evidence-based nutrition group were (2.07±0.14) g/L, (33.79±1.03) g/L, and (119.25±1.14) g/L, respectively, which were significantly higher than (1.78±0.11) g/L, (28.63±0.94) g/L,and (103.71±1.09) g/L in the routine group (P<0.05); the SAS and SDS scores in the evidence-based nutrition groupwere (47.21±1.49) points and (45.85±2.28) points, respectively, which were significantly lower than (59.85±5.33) pointsand (54.36±3.15) points in the routine group (P<0.05); the physical, social, cognitive, and emotional function scores in the evi-dence-based nutrition group were (90.15±1.05) points, (70.35±3.51) points, (92.03±1.43) points, and (87.42±3.35) points, re-spectively, which were significantly higher than (85.42 ± 1.01) points, (64.89 ± 2.86) points, (87.14 ± 1.27) points, and(78.14±2.52) points in the routine group (P<0.05). The incidence of bone marrow suppression, acute radiation proctitis,and acute gastrointestinal reactions in the evidence-based nutrition group were 70.15%, 52.24%, 76.12%, respectively,which were significantly lower than 85.07%, 73.13%, and 89.55% in the routine group (P<0.05). The interruption rate ofradiotherapy in the evidence-based nutrition group was 0, which was significantly lower than 8.96% in the routine group(P<0.05). Conclusion Nutrition management based on evidence-based theory can improve the nutritional status of pa-tients with cervical cancer undergoing radiotherapy, regulate their emotional state, enhance their radiation tolerance, re-duce the incidence of adverse reactions, and improve their quality of life.
      【Key words】 Cervical cancer; Evidence-based theory; Nutrition management; Radiotherapy; Nutritional status;Quality of life