住院癌症病人營養狀況之探討
中文摘要
營養不良是癌症病人最常面對的問題之ㄧ，然而國人目前鮮少對此此課題深入 探究。本橫斷式研究旨在探討台北某醫學中心三所腫瘤病房住院癌症病人之營 養狀況。共收集 132 位個案，資料內容包括病患基本資料、症狀嚴重程度、身 體質量指數（ body mass index; BMI ）、身體功能狀態（ Karnofsky performance status; KPS ）及營養篩檢 - 迷你營養評估（ Mini-Nutritional Assessment; MN
A ）。其中 30 位個案進一步收錄 72 小時飲食攝取訪談記錄。資料分析以描述 性統計、單因子變異數分析（ one way ANOVA ）、事後檢定（ Scheffe’s post h oc ）、皮爾森相關（ Pearson’s correlation ）、多元逐步回歸（ multiple stepwise regression ）。研究結果發現：（ 1 ） MNA 總分平均值為（ ±SD ） 17.37±4.76
；超過一半的個案（ n=67, 50.8% ）被歸類為潛在性營養不良及 53 例病患（ 40 .2% ）為營養不良。（ 2 ） 72 小時飲食攝取資料分析顯示總熱量低於一般健康 人，特別是脂肪的攝取最為偏低；以及（ 3 ）逐步迴歸分析指出整體症狀嚴重 程度、 BMI 、 KPS 評分、血紅素值、頭頸癌 / 食道癌及腸胃道惡性腫瘤的診斷 能顯著預測以 MNA 總分作為評估的營養狀況（ R2 ＝ 69.9 % ）。本研究結果 提出癌症病患的營養仍然是個需要努力的課題。為改善癌症病患營養狀況，本 研究建議對此問題及其相關因素應投注更多的關懷。
關鍵詞：營養、癌症、症狀、身體功能狀態（ KPS ）、迷你營養評估（ MN A ）
Nutritional Status in Hospitalized Cancer Patients
英文摘要
Malnutrition is one of the most common problems faced by cancer patients, yet few studies have explored this problem. The purposes of this cross-sectional study were to investigate the nutritional status of hospitalized cancer patients in three inpatient oncology wards at a medical center in Taipei. Data collected on 132 subjects includ ed background and disease-related information, symptom severity, Body Mass Inde x (BMI), performance status (by Karnofsky Performance Status, KPS) and nutrition al screening (by Mini-Nutritional Assessment, MNA). Thirty of these subjects were further interviewed about their 72-hour dietary intake. Data were analyzed by descr iptive statistics, one-way ANOVA, Scheffe’s post-hoc test, Pearson’s correlation, a nd multiple stepwise regression. The results showed that: (1) the mean (±SD) MNA score was 17.37±4.74; more than half the subjects (n=67, 50.8%) were categorized as “at nutritional risk” and 53 (40.2%) were identified as “malnourished”; (2) analy sis of the 72-hour dietary intake data showed that total caloric intake was less than t hat of normal healthy people, especially for fat intake; and (3) stepwise multiple re gression analysis indicated that overall symptom severity, BMI, KPS scores, hemog lobin, diagnosis with head and neck cancers and GI cancers significantly predicted nutritional status as assessed by MNA scores (R2 =69.9%). These results suggest th at the nutrition of cancer patients is still a problem. To improve cancer patients’ nut ritional status, the authors recommend that more attention be devoted to this issue a nd its related factors.
