| Objective: To investigate the incidence of nutritional risk and the use of nutritional support in hospitalized patients with head and neck cancers(HNC),and the effect of parenteral and enteral nutrition support on the clinical outcome of HNC patients with nutritional risk.Methods: Nutritional risk screening 2002 was performed in HNC patients who were hospitalized between September 2015 to December 2016 in two hospitals in Chongqing,Patients were assessed for nutrition support way and time by Nutrition support usage form During the period of hospitalization,case report form on clinical outcome was used to collect Various related indicators for surgical patients with nutritional risk.These patients were divided into nutrition support group and homemade diet group by whether they have accepted professional nutrition support.The difference of clinical data which include Nutritional and biochemical indexes,complications,hospitalization time,hospitalization expenses were compared and analyzed.Results:1.the status of nutritional support in patients with HNC :340 patients were investigated in this study,a total of 335 questionnaires were recovered,recovery rate was 98.5%.The incidence of nutritional risk(NRS score≥ 3)was 36.7%(123/335).The rate of nutritional support in patients with nutritional risk was 39%(48/123).2.Effect of nutritional support on clinical outcomes in HNC patients : the results showed that there was no significant difference in the absolute value of lymphocyte in seventh days after operation in the self-made diet group(p >0.05),while there was a significant increase in the nutritional support group.(p <0.05);in seventh days after operation,Statistically significantly less hemoglobin loss in the Nutritional support group(p <0.05),changes in other nutritional indexes(ALB,LYM,PA,WBC)between the two groups of patients had no significant difference(P >0.05).There was no significant difference in the incidence of infectious complications between the two groups(p > 0.05),but There were significant differences between the two groups in the length of stay and the cost of hospitalization(p=0.00).3.Influencing factors of hospital stay in HNC patients: Multivariate analysis showed that gender,nutritional risk,number of biopsies,type of disease,therapeutic modalities and Infectious complications were independent factors of length of stay(p<0.05),but nutrition support,age,BMI,type of medical insurance and non infectious complications had no effect on length of stay(P > 0.05).Conclusion:1.In this study,the incidence of nutritional risk was high in patients with HNC,but the nutritional support rate did not reach the expected standard.2.nutritional support have a positive impact on the changes of nutritional status index of patients,but the effect on the rate of complications is not significant.3.The number of biopsy,sex,disease types,nutritional risk,treatment and complications are independent risk factors of hospitalization time,but nutritional support,BMI,age,type of medical insurance,non infectious complications are not independent factors affecting the hospitalization time of patients. |
