论著

消化系统恶性肿瘤患者营养风险及营养知信行分析

Research on nutritional risk and nutritional knowledge - attitude - behavior among patients with digestive system malignant tumors

:491-499
 
      目的 调查消化系统恶性肿瘤患者营养风险、营养知识-态度-行为(知信行)水平的现状,探究各因素是否对患者的营养风险、营养知信行水平具有影响,并分析两者之间的相关性。方法 选取中山大学附属第八医院(深圳福田)2024年2月—10月的244例消化系统恶性肿瘤患者为研究对象,采用一般资料调查表、营养风险筛查NRS2002量表以及消化系统肿瘤患者营养知信行问卷进行调查,数据收集后进行统计分析,从而研究消化系统恶性肿瘤患者营养筛查风险与营养知信行水平的现状、影响因素及两者间的相关性。结果 69.3%的消化系统恶性肿瘤患者存在营养风险,营养风险评分为(2.72±1.42)分。消化系统恶性肿瘤患者营养知识水平得分为(12.30±5.26)分、营养态度水平得分为(14.80±2.68)分、营养行为水平得分为(22.82±4.55)分、营养知信行水平总分为(49.96±9.50)分。家庭经济收入是患者营养风险水平的核心影响因素(P<0.05),学历水平是患者营养知信行水平的核心影响因素(P<0.05)。消化系统恶性肿瘤患者营养风险水平与营养知信行的总体水平呈负相关(r=-0.143,P<0.05)。结论 消化系统恶性肿瘤患者的营养知信行水平总体处于中等水平,但普遍存在营养风险较高的情况。在患者治疗期间实施个性化营养健康宣教至关重要,这将有助于提升患者的营养知识水平,从而整体性改善其营养知信行素养并降低其营养风险,但在进行营养宣教和制定个性化营养方案时应充分考虑患者的家庭经济收入及学历水平。
    Objective To explore the nutritional risk and nutritional knowledge-attitude-behavior status of patients with digestive system malignant tumors,to analyze the influencing factors of nutritional risk,nutritional knowledge-attitude-behavior,and explore the correlation between them.Methods From February 2024 to October 2024,244 patients with digestive system malignant tumors at the Eighth Affiliated Hospital of Sun Yat-sen University were selected as the research subjects.A general information questionnaire,Nutritional Risk Screening 2002,and digestive system tumor patient nutrition knowledge-attitude-behavior questionnaire were used to study the influencing factors and correlations between the nutritional screening risk and nutritional knowledge-attitude-behavior in patients with digestive system malignant tumors.Results There were 69.3% of the patients with digestive system malignant tumors had nutritional risk score ≥3,and the overall score was(2.72±1.42).The scores of nutritional knowledge,attitude,behavior and total score of digestive system malignant tumors patients were(12.30±5.26),(14.80±2.68),(22.82±4.55)and(49.96±9.50),respectively.Family economic income was the core influencing factors of nutritional risk in patients with digestive system malignant tumors,while educational level was the core influencing factor of nutritional knowledge-attitude-behavior in patients with digestive system malignant tumors.The nutritional risk level of patients with malignant tumors of the digestive system was significantly negatively correlated with the overall level of nutritional knowledge-attitude-behavior.Conclusions The nutritional knowledge-attitude-behavior level of patients with malignant tumors of the digestive system is generally at a medium level,but there is a widespread situation of relatively high nutritional risk.It is extremely important and necessary to conduct personalized nutrition knowledge education for patients during their treatment period,which will help enhance patients’ nutritional knowledge level,thereby comprehensively improving their nutritional knowledge-attitude-behavior literacy and reducing their nutritional risks.However,when conducting nutrition education and formulating personalized nutrition plans,the patient’s family economic income,medical payment methods and educational level should be fully considered.

临床诊疗

甲强龙静脉注射应用于老年腹部全麻术患者的价值分析

The Value Analysis of Solu-Medrol Intravenous Injectin Applied on Old aged Abdomen General Anesthesia

:93-95
 
目的 研究分析甲强龙静脉注射对老年腹部全麻术患者血流动力学和呼吸动力学的影响。方法 选取2014年3月—2015年3月拟于我院行腹部全麻手术的老年患者76例,随机分为实验组和对照组,每组38例,均对其行全身麻醉。两组病人麻醉诱导用药咪达唑仑0.05 mg/kg,速眠安0.15 mg/kg,乙咪酯 0.2 mg/kg,气管插管后连接麻醉呼吸机。麻醉维持咪达唑仑和速眠安各0.05 mg/kg,给予实验组静脉注射甲强龙1 mL(40 mg),对照组静脉注射生理盐水1 mL。记录两组患者给药前(T1)、给药后10 min(T2)、20 min(T3)、30 min(T4)、40 min(T5)的气道峰压(Ppeak)、气道平台压(Pplat)、肺的顺应性(Compl)、气道阻力(Raw)等呼吸动力学参数值。以及两组患者给药前20 min(T0)和T1~T3患者的收缩压(SBP)、舒张压(DBP)、平均动脉压(MAP)和心率(HR)等血流动力学参数值,并于以上各时间点采取两组患者静脉血测定其血浆中cAMP和cGMP含量。观察比较两组患者各时间点的数据变化以及拔管后10 min(T6),15 min(T7)和35 min(T8)的RAMSAY镇静评分和RASS评分。结果 实验组在T2~T5时Compl明显增高,而同期Ppeak、Pplat、Raw则降低(P<0.05)。与对照组相比较,实验组在T0到T4的SBP、DBP、MAP和HR无差异,且各时间点的数值低于同期对照组。两组患者在T0和T3cAMP和cGMP含量比较无差异,实验组cAMP和cGMP含量在T1和T2时低于对照组,两组患者在T8时的Ramsay评分和RASS评分比较差异无统计意义,但实验组患者在T6和T7时的镇静评分高于对照组(P<0.05),而同一时间点的RASS躁动——镇静量表评分则低于对照组(P<0.05)。结论 甲强龙静脉注射能稳定老年腹部全麻术患者的血流动力学和呼吸动力学,抑制手术过程中的应激反应,改善苏醒质量和镇静效果,值得临床上推广使用。
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