| Objective: To investigate the effect of NRS2002-based individualized nutrition management scheme on the nutritional status and quality of life of postoperative patients with gastric cancer undergoing chemotherapy,help clinical staff to develop more perfect nutrition intervention measures,for solving the practical problems,improve the therapeutic effect and quality of life of patients,and provide a reference basis for tumor patients nutrition treatment.Methods: The subjects of this study were 122 postoperative patients with gastric cancer undergoing chemotherapy admitted to the hospital from September 2017 to December 2018.Sixty cases of postoperative patients with gastric cancer undergoing chemotherapy admitted from September 2017 to February 2018 were selected as the control group,and 62 cases of postoperative patients with gastric cancer undergoing chemotherapy admitted from July to December 2018 were selected as the intervention group.The intervention interval was from March to June 2018.Control group: routine nutrition management scheme.After admission,the nutrition risk screening2002(NRS2002)was conducted,and the patients with nutrition risk were given routine nutrition support.Intervention group: individualized nutrition management scheme based on NRS2002 results.To investigate the situation from the beginning of chemotherapy to the fifth chemotherapy,a total of 6 times:before chemotherapy was the T0 stage,the first to the fifth chemotherapy were T1,T2,T3,T4,T5 stage.Records the results of nutritional risk screening(NRS2002),body mass index(BMI),hemoglobin(HB),albumin(propagated)and pre-albumin(PA),retinal binding protein(RBP),and the scores of quality of life questionnaire core 30(Version 3.0)(QLQ-C30(V3.0))and quality of life questionnaire of stomach22(QLQ-STO22)(Chinese version).Contrast the nutritional status and quality of life of two groups of patients.Results:1.There were no significant differences between the two groups in gender,age,nationality,marital status,education level,occupation,smoking history,drinking history,clinical stage,operation method,chemotherapy regimen,allergy history,and chronic medical history(P>0.05).2.NRS2002 score results:trends of the two groups:as the number of chemotherapy increased,NRS2002 scores of the control group and the intervention group increased gradually.Comparison of the two groups:there were statistically significant differences between the two groups at T3,T4 and T5stages(P<0.05).Repeat measure anova:both grouping factor and time factor had an influence on NRS2002 score(P<0.05).There was an interaction between time factors and grouping factors(P<0.05).3.BMI results:trends of the two groups:as the number of chemotherapy increased,the BMI of the control group was getting lower and lower,which was significantly decreased in the T1 stage,basically maintained the same level at T2 and T3 stages,and significantly decreased at T4 and T5 stages.The BMI of the intervention group increased first and then decreased,and the fluctuation level was not distinct.Comparison of the two groups:there were statistically significant differences in BMI between the two groups at T1,T2,T3,T4 and T5stages(P<0.05).Repeat measure anova:grouping factors had an influence on the BMI of patients(P<0.05).Time had no effect on BMI(P>0.05).There was no interaction between time factors and grouping factors(P>0.05).4.Laboratory index results: trends of the two groups:HB,ALB,PA and RBP levels of patients in both groups were lower than normal during the study period;as the number of chemotherapy increased,HB,ALB,PA and RBP in the control group decreased gradually;HB,PA,and RBP in the intervention group increased gradually.Comparison of the two groups:there were statistically significant differences in HB between the two groups at T3,T4 and T5 stages(P<0.05).ALB and PA were significantly different in the T1,T2,T3,T4,and T5phases(P<0.05).RBP at T4 and T5 stages showed a statistically significant difference between the two groups(P<0.05).Repeat measure anova:grouping factors affected HB,ALB,PA and RBP(P<0.05).Time factor had no effect on HB,ALB,PA and RBP(P>0.05).There was an interaction between time factor and grouping factor in ALB,PA and RBP(P<0.05).5.EORTC QLQ-C30(V3.0)score results:(1)Total health score results: trends of the two groups:as the number of chemotherapy increased,the total health score of patients in the two groups gradually increased.Comparison of the two groups:there were statistically significant differences in the total health status scores between the two groups at T4 and T5(P<0.05).Repeat measure anova:grouping factors had no effect on patients' total health status scores(P>0.05),while time factors had an effect onpatients' total health status scores(P<0.05),and there was an interaction between time factors and grouping factors(P<0.05).(2)Functional items score results: trends of the two groups:as the number of chemotherapy increased,scores of physical function,role function,social function and cognitive function of patients in the control group and the intervention group increased,while scores of emotional function in the control group decreased gradually and increased gradually in the intervention group.Comparison of the two groups:the difference in physical function between the two groups at T4 and T5 stages was statistically significant(P<0.05).The difference of role function between the two groups at T1,T2,T3,T4,and T5 stages was statistically significant(P<0.05).The difference of emotional function and social function between the two groups at T1,T2,T3,T4,and T5 stages was statistically significant(P<0.05).There were statistically significant differences in cognitive function between the two groups at T2,T3 and T5 stages(P<0.05).Repeat measure anova:grouping factors had an influence on role function,emotional function,cognitive function and social function(P<0.05).Time factors had an effect on physical function,role function,social function and cognitive function(P<0.05).There was an interaction between time factor and grouping factor in role function and emotional function(P<0.05).(3)Symptom item score results: trends of the two groups:as the number of chemotherapy increased,the scores of fatigue,nausea,vomiting,pain,and shortness of breath in the control group increased,while those of constipation and insomnia decreased.The scores of pain,insomnia,constipation,and diarrhea in the intervention group showed a downward trend.Comparison of the two groups:there were statistically significant differences in Nausea and vomiting between the two groups at T4 and T5 stages(P<0.05).There were statisticallysignificant differences in shortness of breath between the two groups at T3,T4 and T5 stages(P<0.05).There were statistically significant differences in Insomnia and appetite between the two groups at the T5 stage(P<0.05).Repeat measure anova:grouping factors affected the scores of nausea,vomiting,pain,shortness of breath and appetite(P<0.05).Time factors had an effect on constipation and economic difficulty(P<0.05).There was no interaction between time factors and grouping factors in the nine symptom items(P>0.05).6.EORTC QLQ-STO22 score resultsTrends of the two groups:as the number of chemotherapy increased,the scores of eating disorders and dry mouth items in the control group increased.In the intervention group,the scores of pain,eating disorder,anxiety and dry mouth showed a downward trend,while the scores of body image and hair loss(when there was hair loss)were first increased and then decreased in both groups.Comparison of the two groups:there were statistically significant differences in pain between the two groups at the T5 stage(P<0.05).There were statistically significant differences in Eating disorders and taste changes between the two groups at T3 ? T4 and T5 stages(P<0.05).There were statistically significant differences in the dry mouth between the two groups at T4 and T5 stages(P<0.05).There were statistically significant differences in the effects of hair loss(with hair loss)between the two groups at T1 ? T2 ? T3 ? T4 and T5 stage s(P<0.05).Repeat measure anova:grouping factors had an influence on eating disorder,taste change and hair loss(when there was hair loss)(P<0.05).Time factors had an influence on re-flux and alopecia(P<0.05).There was an interaction between time and grouping factors in eating disorder,dry mouth and hair loss(when hair loss was present)(P<0.05).Conclusion The individualized nutrition management scheme based onNRS2002 is helpful to improve the nutritional status and the quality of life of postoperative patients with gastric cancer undergoing chemotherapy. |
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