| Objective:To explore the effect of nutritional intervention on the nutrition status and quality of life by providing MDT nutritional support mode for patients with digestive tract cancer chemotherapy,and to provide scientific clinical basis for improving the nutritional status and quality of life of such patients.Methods:A total of 92 patients who receiving chemotherapy for gastrointestinal malignancy in the first people's hospital of Jingzhou city from October 2017 to October 2018 were randomly divided into experimental group and control group,with 46 cases in each group.Patients in the control group received conventional nutritional treatment and nursing for tumor chemotherapy,and patients in the experimental group received MDT nutritional support mode intervention on the basis of the control group.To observe and compare the difference of nutritional status and quality of life between the two groups before intervention(before chemotherapy),21 days after intervention and one month after follow-up.Results:(1)Baseline comparisonThere was no statistically significant difference in general information(age,gender,occupation,education level,marital status,family economy,status,tumor site,stage and chemotherapy regimen)of the patients in the two groups before intervention(p>0.05).Before the intervention,the objective nutritional status indicators(BMI),serum albumin(ALB),hemoglobin(HB),PG-SGA score and EORTC QLQ-C30 score of the patients in the two groups showed no significant difference(p>0.05),Which was comparable.(2)Nutritional statusa.comparison of objective nutritional indexes between the two groups:At the two time points of 21 days after intervention and one month after follow-up,the objective nutritional indexes ALB and HB in the experimental group were higher than those in the control group.Using two factors of three levels of repetitive measure analysis of variance method to compare the differences between repeated measurement of two groups of objective nutrition indicators at three time points(before intervention,intervention after 21 days and follow-up after a month).The results showed that there were statistically significant difference between the two groups of patients with BMI,HB,in the time main effect of difference and intervention main effect of difference,and also in the interaction between intervention factor and time factor(p<0.05).Regardless of interference factors,two groups of patients with HB,propagated value changes over time;Regardless of time,HB and ALB values of subjects with different intervention levels were different.At the same time,the variation trend was different at different time points under different intervention levels.b.comparison of PG-SGA scores of subjective nutrition evaluation indexes between the two groups:After 21 days of intervention,there was no difference in PG-SGA score between the experimental group and the control group statistical significance(x~2=4.444,p=0.108).After one month of follow-up,the difference between the two groups was statistically significant(x~2=7.541,p=0.023).There was a statistical difference between the experimental group after one month of follow-up and before intervention(x~2=20.487,p=0.000).There was a statistical difference between one month of follow-up and 21days of intervention(x~2=4.519,p=0.104).There was a statistically significant difference after 21 days of intervention and before intervention(x~2=7.297,p=0.026).There was no significant difference between the control group and the control group after one month's follow-up(x~2=3.853,p=0.146)and after 21 days'intervention(x~2=2.424,p=0.298),and there was no significant difference between the control group and the control group after 21 days'intervention(x~2=0.224,p=0.894).(3)Quality of lifeAt the two time points of 21 days after intervention and one month after follow-up,the physical function,emotional function and the scores of role function,cognitive function,social function and general health status were higher than those of the control group.In the symptom domain,except the economic difficulty score was higher than that of the control group,all other scores were lower than that of the control group.Two factors and three levels of repeated measurement anova were used to compare the differences between the two groups in repeated measurement of QLQ-C30 at three different time points(before intervention,21 days after intervention,and one month after follow-up).The results showed that,except for economic difficulties,the main effect differences of QLQ-C30 scores in other fields in the two groups were statistically significant(P<0.05),indicating that without considering intervention factors,QLQ-C30scores of subjects in different intervention levels varied with time.Two groups of the patient's overall health and physical,emotional,cognitive,social,and other areas of the functional and fatigue,nausea,vomiting,pain,insomnia,loss of appetite and constipation,and other areas of the symptoms score intervention effect of main difference was statistically significant(P<0.05),that is,don't consider the time factor,different intervention level of two groups of patients with overall health and body,functional areas such as emotional,cognitive,social,and fatigue,nausea,vomiting,pain,insomnia,loss of appetite and constipation,and other areas of the symptoms score.Overall health and body,emotion,character,social functional areas such as pain and nausea and vomiting,loss of appetite,insomnia,and constipation and other symptoms score with interaction between intervention factor and time factor(p<0.05),that is,two groups of patients'overall health and body,emotion,character,functional areas such as society,and nausea and vomiting,loss of appetite,insomnia,pain and symptoms such as constipation score at different levels of intervention have different under the different time points.Conclusion:Multidisciplinary team(MDT)nutritional support mode nutritional intervention can improve the nutritional status of patients undergoing chemotherapy for gastrointestinal cancer and improve their quality of life. |
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