严思又 罗蕾

摘  要：目的  探討基于微信平台的营养咨询与营养教育在小细胞肺癌患者化疗出院后的家居康复指导中的应用。方法  采用方便取样法选取四川省肿瘤医院胸部肿瘤内科2017年1月～10月的52例顺利完成第1周期～第6周期EP化疗方案出院后的小细胞肺癌患者，随机分为对照组25例与观察组27例，每组观察时间均为7个月（包括患者化疗的全部周期及3个月后的复查），在院时采用常规的营养健康教育，对照组在患者出院时由营养护士进行强化营养教育，发放肿瘤患者营养治疗教育手册，出院后也可拨打病区电话进行咨询，观察组出院后不定时地通过微信平台包括私信、微信群交流咨询，朋友圈及微信公众号的文章、视频推送进行健康教育，比较两组患者的营养状况、对6个治疗周期效果的满意度以及生活质量。结果  再次入院或复查时，观察组患者的营养风险评分、化疗后不良反应持续时间、及住院时间及生活质量等明显优于对照组，差异有统计学意义（P<0.05）。结论  基于微信平台的营养咨询与营养教育在小细胞肺癌患者化疗出院后的家居康复指导中取得良好的效果，具有省时、方便、灵活的特点，能随时对出院患者的营养状况进行指导和沟通，可以降低营养不良发生的风险，保证院外健康教育的连续性，提高患者整个治疗周期的满意度，提升患者的生活质量。

关键词：微信平台;营养咨询;营养教育;小细胞肺癌化疗;家居康复指导

中图分类号：R47    文献标识码：A    文章编号：1009-8011（2021）-3-0010-05

Abstract： Objective  To explore the application of nutrition consultation and nutrition education based on WeChat platform in home rehabilitation guidance of patients with small cell lung cancer after chemotherapy and discharge from hospital. Methods   A convenient sampling method was used to select Grade 3A in Sichuan Province. From January 2017 to October 2017， 52 patients with small cell lung cancer（SCLC） who had successfully completed the first to 6th cycles of EP chemotherapy were selected. They were randomLy divided into control group （n =25） and observation group （n=27）. The observation time of each group was 7 months （including the whole cycle of chemotherapy and the reexamination after 3 months）. Routine nutrition and health education was used in hospital. Nutrition nurses carry out intensive nutrition education， distribute nutrition treatment education manuals for cancer patients， and call the ward telephone after discharge for consultation. The observation group regularly uses the WeChat platform to include private mail， WeChat group exchanges and consultation， articles by official account on WeChat， video push for health education. The nutritional status， satisfaction with the effect of six treatment cycles and quality of life were compared between the two groups. Results  When re-admitted or re-examined， the nutritional risk scores， duration of adverse reactions， hospitalization time and quality of life in the observation group were significantly better than those in the control group（P<0.05）. Conclusions  The nutrition consultation and nutrition education based on WeChat platform has achieved good results in home rehabilitation guidance of patients with small cell lung cancer after chemotherapy and discharge from hospital. It has the characteristics of saving time， convenience and flexibility. It can guide and communicate the nutritional status of discharged patients at any time， can reduce the risk of malnutrition， ensure the continuity of health education outside hospital， improve the satisfaction of patients during the whole treatment cycle， and improve the quality of life of patients.

Keywords： WeChat platform;Nutrition consultation;Nutrition Education; Chemotherapy for small Cell Lung Cancer; Home Rehabilitation guidance

目前，综合治疗是治疗小细胞肺癌成功的关键，以全身化疗为主，联合放疗及手术为主要治疗手段，但在临床上使用的化疗药物均可引起不同程度的毒副反应，其中消化道反应表现为食欲下降、恶心、呕吐、便秘腹泻等[1]，甚至还会导致患者存在营养不良的风险等，尤其在患者出院后，患者的营养状况恢复往往比较慢。……