2019 年第 10 期 第 14 卷

基于PDCA循环的营养护理在鼻咽癌放疗患者中的应用效果

Application effect of nutritional nursing based on PDCA cycle on nasopharyngeal cancer patients undergoing radiotherapy

作者：何玉刘莹柯晓冰文珂陈佩娟

英文作者：

单位：510515广州，南方医科大学南方医院放疗科

英文单位：

关键词：鼻咽癌；PDCA；营养护理；营养风险；生活质量

英文关键词：

• 摘要：

• 【摘要】目的    探讨基于PDCA循环的营养护理在鼻咽癌放疗患者中的应用效果。方法    选择2014年9月至2018年2月在南方医科大学南方医院进行放疗的初治鼻咽癌患者156例，根据护理方法的不同分为观察组（80例）与对照组（76例），对照组在放疗8周期间给予常规营养护理；观察组在放疗8周期间给予基于PDCA循环的营养护理，比较2组患者放疗后的总有效率、生活质量评分和放疗前后营养风险筛查(NRS2002)评分≤3分比例、血浆总蛋白与白蛋白水平。结果    放疗8周后，观察组的总有效率高于对照组［75.0%(60/80)比47.4%（36/76）］，差异有统计学意义(χ2=12.572，P<0.001)；躯体功能、角色功能、情绪功能、认知功能和社会功能等维度评分均高于对照组，差异均有统计学意义(均P<0.05)。放疗前，2组NRS2002≤3分比例和血浆总蛋白、白蛋白水平比较差异均无统计学意义（均P>0.05）；放疗后，对照组与观察组NRS2002≤3分比例和血浆总蛋白、白蛋白水平均低于放疗前，且观察组NRS2002≤3分比例低于对照组［7.5%(6/80)比23.7%(18/76)］，血浆总蛋白和白蛋白水平高于对照组［(64±12)g/L比（45±17）g/L、(36±5)g/L比（25±8）g/L］，差异均有统计学意义（均P<0.05）。结论    基于PDCA循环的营养护理在鼻咽癌放疗患者中应用能降低患者营养风险发生率，改善血液营养生化指标，提高放疗疗效与患者的生活质量。

• 【Abstract】Objective    To explore the effect of nutritional care based on PDCA cycle on patients with nasopharyngeal carcinoma undergoing radiotherapy. Methods    A total of 156 patients undergoing initial radiotherapy for nasopharyngeal carcinoma in Nanfang Hospital of Southern Medical University from September 2014 to February 2018 were recruited. According to different nursing methods, they were divided into observation group(80 cases) and control group(76 cases). The control group received routine nutritional care and the observation group was treated with PDCA-based nutritional care during 8 weeks of radiotherapy. Total effective rate, quality of life score, nutrition risk screening(NRS2002) score, plasma total protein and albumin levels were analyzed. Results    After 8 weeks of radiotherapy, the total effective rate in observation group was significantly higher than that in control group［75.0%(60/80) vs 47.4%(36/76)］(χ2=12.572, P<0.001); the scores of physical function, role function, emotional function, cognitive function and social function in observation group were significantly higher than those in control group(all P<0.05). There were no significant differences of the ratio of NRS2002 score≤3, the levels of plasma total protein and albumin between groups before radiotherapy(all P>0.05); after radiotherapy, these indexes significantly decreased in both groups; the ratio of NRS2002 score≤3 in observation group was lower and the levels of plasma total protein and albumin were higher than those in control group［7.5%(6/80) vs 23.7%(18/76), (64±12)g/L vs （45±17）g/L, (36±5)g/L vs （25±8）g/L］（all P<0.05）. Conclusion    Nutritional care based on PDCA cycle can reduce the incidence of nutritional risk, improve blood biochemical indexes for nutrition, the therapeutic effect of radiotherapy and the quality of life in nasopharyngeal cancer patients undergoing radiotherapy.