住院癌症病人營養狀況之探討
Nutritional Status in Hospitalized Cancer Patients
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; MNA）。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 hoc）、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（MNA）
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 included background and disease-related information, symptom severity, Body Mass Index (BMI), performance status (by Karnofsky Performance Status, KPS) and nutritional screening (by Mini-Nutritional Assessment, MNA). Thirty of these subjects were further interviewed about their 72-hour dietary intake. Data were analyzed by descriptive statistics, one-way ANOVA, Scheffe’s post-hoc test,
Pearson’s correlation, and 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) analysis of the 72-hour dietary intake data showed that total caloric intake was less than that of normal healthy people, especially for fat intake;
and (3) stepwise multiple regression analysis indicated that overall symptom severity, BMI, KPS scores, hemoglobin, diagnosis with head and neck cancers and GI cancers significantly predicted nutritional status as assessed by MNA scores (R2
=69.9%). These results suggest that the nutrition of cancer patients is still a problem. To improve cancer patients’ nutritional status, the authors recommend that more attention be devoted to this issue and its related factors.
