刘伟玲　　张丽珍　　张海湘　　柳鑫霞　　李伟文

[摘要] 目的 探讨强化营养支持治疗模式在晚期肺癌相关性厌食患者中的应用。 方法 选取2018年1月至2019年12月我院门诊就诊的晚期肺癌相关性厌食患者90例，采用抛银币法分为强化组和常规组，每组各45例。两组患者均予以常规抗肿瘤治疗治疗，常规组患者在此基础上予常规干预措施。强化组患者在常规组基础上予以强化营养支持治疗，两组患者均治疗6周。观察两组患者治疗前后血清营养相关指标[血清血红蛋白（Hb）、白蛋白（ALB）和转铁蛋白（TRF）变化情况，并比较食欲恢复情况。 结果 治疗6周后，强化组患者血清Hb、ALB和TRF水平较治疗前明显上升，差异有统计学意义（P<0.05），而常规组患者治疗前后变化不明显（P>0.05），且治疗后强化组患者血清Hb、ALB和TRF水平高于常规组，差异有统计学意义（P<0.05）;同时治疗6周后，强化组患者食欲恢复情况明显优于常规组，差异有统计学意义（χ2=4.860，P<0.05）。 结论 强化营养支持治疗模式用于晚期肺癌相关性厌食患者不仅能促进营養状态的改善，减少营养不良的发生，而且能促进患者改善食欲的好转，改善其厌食情况。

[关键词] 晚期肺癌;相关性厌食;强化营养支持治疗模式;营养指标;食欲恢复

[中图分类号] R734.2          [文献标识码] B          [文章编号] 1673-9701（2021）14-0107-04

Application of intensive nutritional support treatment mode in patients with advanced lung cancer-related anorexia

LIU Weiling   ZHANG Lizhen   ZHANG Haixiang   LIU Xinxia   LI Weiwen

Department of Respiratory and Critical Care Medicine， Lishui Central Hospital， Lishui   323000， China

[Abstract] Objective To explore the application of intensive nutritional support treatment mode in patients with advanced lung cancer-related anorexia. Methods Ninety patients with advanced lung cancer-related anorexia who visited our outpatient clinic from January 2018 to December 2019 were selected and divided into the intensive group and the conventional group by the silver coin method， with 45 cases in each group. Patients in the two groups were treated with conventional anti-tumor therapy， and patients in the conventional group were treated with conventional interventions on this basis. Patients in the intensive group were given intensive nutritional support treatment on the basis of the conventional group. Patients in both groups were treated for 6 weeks. The changes of serum nutritional indicators [serum hemoglobin（Hb）， albumin （ALB） and transferrin （TRF） before and after treatment between the two groups were observed， and the recovery of appetite was compared. Results After 6 weeks of treatment， the levels of serum Hb， ALB and TRF in the intensive group were significantly higher than those before the treatment， and the differences were statistically significant （P<0.05）， while the patients in the conventional group did not change significantly before and after treatment （P>0.05）. Serum Hb， ALB and TRF levels of patients in the intensive group were higher than those in the conventional group after treatment， and the difference was statistically significant（P<0.05）. After 6 weeks of treatment， the appetite recovery of patients in the intensive group was significantly better than that of the conventional group， and the difference was statistically significant（χ2=4.860， P<0.05）. Conclusion The intensive nutritional support treatment mode used in patients with advanced lung cancer-related anorexia can not only improve the nutritional status and reduce the occurrence of malnutrition， but also promote the improvement of patients' appetite and improve their anorexia.

[Key words] Advanced lung cancer; Related anorexia; Intensive nutritional support treatment mode; Nutritional indicators; Appetite recovery

肺癌是一种呼吸科常见的恶性肿瘤，大多数起病隐匿，症状无特异性，早期诊断颇难，发现时既晚期，失去了治疗机会[1-2]。肿瘤相关性厌食是晚期肿瘤较常见的伴随症状，表现为食欲下降或缺乏、体重下降，长期可引起低蛋白、贫血或营养不良，严重时出现恶病质，缩短了患者生存时间[3-4]。目前研究认为常规营养支持对肿瘤相关性厌食患者的治疗效果有限，对其营养不良状况往往难以逆转。强化营养支持治疗是根据患者的不同的营养状况，制定个体化的营养支持方案以改善和补偿其营养不良或过剩状况，以达到营养平衡的需求，近年来逐渐应用于肿瘤相关性厌食患者，并取得了一定的效果[5-6]。……