口腔癌老年患者合并营养不良的危险因素及防治策略^*

Investigation of risk factors for malnutrition in elderly patients with oral cancer and control strategies

摘要

目的 探究口腔癌老年患者合并营养不良的危险因素, 并提出相应防治策略。方法 选取2019年1月—2024年12月自贡市第一人民医院就诊的160例口腔癌老年患者作为研究对象, 通过调查问卷收集患者基本资料 (回收有效问卷156分) 并采用吞咽功能障碍表进行调查。采用营养风险筛查量表2002 (NRS ^{2002) 进行分组, 将NRS评分<3分的102例患者纳入营养正常组, NRS评分≥3分的54例患者纳入营养不良组, 比较两组年龄、性别、吸烟、饮酒、嚼槟榔、文化程度、婚姻状况、原发病灶直径、肿瘤类型、肿瘤分期、吞咽障碍、治疗方式、营养支持方式, 将单因素分析中差异有统计学意义的纳入多因素logistic回归分析探讨口腔癌老年患者合并营养不良的危险因素。结果 单因素分析显示两组吸烟、肿瘤分期、吞咽障碍、营养支持方式比较, 差异均有统计学意义 (P<0.05); 多因素logistic回归分析显示吸烟、吞咽障碍、营养支持方式是口腔癌老年患者合并营养不良的独立危险因素 (P<0.05)。结论 口腔癌老年患者合并营养不良的发生与吸烟、吞咽障碍、营养支持方式等因素密切相关, 可通过给予营养筛查与评估、饮食干预、口腔清洁护理与功能锻炼等综合防治策略, 改善患者营养状况, 提高患者生活质量和治疗效果。}

Abstract

Objective To investigate the risk factors for malnutrition in elderly patients with oral cancer and propose corresponding control strategies. Methods 160 elderly patients with oral cancer who were treated at First People's Hospital of Zigong City from January 2019 to December 2024 were selected as study subjects. Patient demographics were collected via questionnaires (156 valid questionnaires returned) and assessed using the Dysphagia Scale. The Nutritional Risk Screening 2002 (NRS 2002) was used to for grouping, 102 patients with NRS scores <3 were assigned to the normal nutrition group, while 54 patients with NRS scores ≥3 were assigned to the malnutrition group. Comparisons were made between the two groups for age, gender, smoking, alcohol consumption, betel nut chewing, educational attainment, marital status, primary lesion diameter, tumor type, tumor stage, dysphagia, treatment modality, and nutritional support method. Factors showing statistically significant differences in univariate analysis were included in multivariate logistic regression to explore risk factors for malnutrition in elderly oral cancer patients. Results Univariate analysis showed significant differences in smoking, tumor stage, swallowing disorders, and nutritional support between the two groups (P < 0.05). Multivariate logistic regression analysis showed that smoking, swallowing disorders, and nutrition support were independent risk factors for malnutrition in elderly patients with oral cancer (P<0.05). Conclusion The occurrence of malnutrition in elderly patients with oral cancer is closely related to factors such as smoking, swallowing disorders, and nutrition support. Intervention measures can be developed based on these factors to prevent the occurrence of malnutrition. Comprehensive control strategies such as nutrition screening and assessment, diet intervention, oral cleansing and care, and functional exercise can be implemented to improve the patients’ nutritional status and enhance the quality of life as well as therapeutic effect.

关键词

口腔癌 / 营养不良 / 防治策略

Key words

Oral cancer / Malnutrition / Control strategy

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基金资助

^*四川省自然科学基金项目 (面上项目)(2024NSFSC0636363)