肿瘤患者食欲评价和调节的专家共识

食欲下降是肿瘤患者常见症状,癌性厌食/恶液质综合征在晚期肿瘤患者中发病率较高。肿瘤患者因营养摄入不足,会出现全血细胞减少、体重下降、脂肪组织和骨骼肌减少,导致患者免疫力降低,治疗耐受性下降,治疗机会减少,并发症增加,不利于抗肿瘤治疗措施的实施。准确评估癌性厌食的过程,无论对研究还是临床救治都极为重要,科学的食欲评价方法和技术不仅是营养工作者客观评价食欲的工具,也是进一步认识和预测营养不良的基础,对改善肿瘤患者营养不良具有积极意义。本共识根据国内外现有研究证据,对该领域的研究结果进行系统总结。从肿瘤、营养与食欲的关系出发,分析癌性厌食的发生发展机制,总结不同情况下肿瘤患者的食欲评价方法,并给出专家推荐意见。结合我国膳食现状和特点,从临床、营养、护理、中医的角度提出调节食欲的方法,科学规范癌性厌食管理策略,以便临床医师、临床营养专业人员、护士等医疗保健人员应用,更好地为肿瘤患者服务。

Expert consensus on appetite assessment and regulation in cancer patients

Loss of appetite is a common symptom in cancer patients,and the incidence of cancer anorexia cachexia syndrome is higher in advanced cancer patients.Due to insufficient nutrition intake,cancer patients will suffer from pancytopenia,weight loss,loss of fat tissue and skeletal muscle,resulting in decreased immunity,decreased treatment tolerance,reduced treatment opportunities,and increased complications.These problems are not conducive to the implementation of anti-cancer treatment measures.Accurate assessment of the process of cancer anorexia is of great importance for both research and clinical treatment.Scientific methods and techniques of appetite assessment are not only tools for nutritionists to evaluate appetite objectively,but also the basis for further understanding and prediction of malnutrition,which have positive significance for improving malnutrition in cancer patients.According to the existing research evidence,this consensus systematically summarized the research results in this field.Starting from the relationship between tumor,nutrition and appetite,this paper analyzed the mechanism of the occurrence and development of cancer anorexia.We summarized the evaluation methods of appetite in tumor patients under different conditions and gave expert recommendations.Combined with the status and characteristics of diet in China,this paper proposed the methods of improving appetite from the perspectives of clinical practice,nutrition,nursing and traditional Chinese medicine.We scientifically standardized the management strategy of cancer anorexia,so as to facilitate the application of clinicians,clinical nutrition professionals,nurses and other medical care personnel to better serve the cancer patients.