| Objective: To investigate the effects of individualized diet guidance on the nutritional status and quality of life of hepatic arterial chemoembolization(TACE)in patients with liver cancer.Methods: From March 2017 to July 2017,140 patients with primary liver cancer who received intervention for the first time in No.1 Hospital of Jilin University were studied.Patients were randomly divided into two groups,68 in the control group and 72 in the intervention group.The control group was guided by regular diet,and the intervention group was given an individualized diet.The contents include: the establishment of personal diet information records,the daily record of nutritional support and diet of patients,according to different patients need heat from nutrition therapy group(nutritional support,team,NST)to develop individualized diet plans,and according to the patient’s energy intake adjustment method of nutritional support with the establishment of We Chat group;strengthening diet;use the mind map making dietary guidance manuals distributed to patients,help to understand the relevant knowledge of nutritional support.Three months later,when the patient was reexamined,the patient’s data were collected again: BMI,ALB,PALB.At the same time,the patient was allowed to complete the NRS-2002 and EORTC QLQ-C30 two scales.Results: 1.Using the card-square test,comparing two groups of patients before tace,nutritional status and quality of life indicators,including: BMI,ALB,Palb,NRS-2002,EORTC qlq-c30,there is no statistically significant difference(p>0.05),the two groups of patients with basic information,including age,gender,marital status and educational level were not statistically significant(p>0.05)and comparable.2.By using the method of repeated measurement variance analysis and two sample independent T test,the indexes of quality of life items and nutritional health status were compared between the two groups before operation,7 days after operation,1 months after operation,3 months after operation,and 6 months after surgery.Patients underwent 6 months of individualized dietary guidance after tace,the body,role,emotion,social,cognitive function and tiredness,nausea and vomiting,loss of appetite,constipation,diarrhea symptom index and overall physical health status in the quality of life,the intervention group and the control group have significant differences,and have statistically significant(p<0.05),The remaining four items,including pain,shortness,insomnia and economic hardship,need further study.3.Two samples of independent T-Test were used to compare BMI,ALB,Palb,NRS-2002 in two groups after operation.The PALB Index intervention group in the Nutrition State project had a significant difference in the 7 days after operation,and had statistically significant(p<0.05).BMI and ALB index intervention group had quicker effect than control group,1 months after Operation had significant difference,statistically significant(p<0.05),NRS-2002 score was lower than control group,and had significant difference in 3 months after operation(p<0.05).4.The incidence of complications in intervention group was lower than that in the control group,and the difference was statistically significant(p<0.05).Conclusion: 1.Patients with primary liver cancer had poor nutritional status,high nutritional risk and low life quality before operation.2.Individualized dietary instruction in nausea and vomiting,loss of appetite,constipation and diarrhea symptoms of the project on short-term results,4 symptoms of the project did not have a significant effect,including pain,shortness,insomnia,loss of appetite,in the functional indicators within 6 months of significant results.3.Individualized dietary guidance can effectively improve the nutritional status of patients after tace,reduce the incidence of malnutrition and reduce the incidence of complications.4.Based on the results of the study,the nursing staff should be individualized dietary guidance,timely and reasonable to develop more consistent with the patient’s nutritional care measures,in order to promote the primary hepatocellular carcinoma patients with tace postoperative recovery. |
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