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標題: | 分析臺灣大學附設動物醫院頭頸部腫瘤患者發生營養不良的風險因子 Risk Factor Assessment of Malnutrition in Head and Neck Cancer Patients of NTUVH |
作者: | Yi-Jiun Chen 陳宜君 |
指導教授: | 李繼忠(Jih-Jong Lee) |
關鍵字: | 營養狀態,營養不良,頭頸部腫瘤,飼養環境,鮮食, nutrition status,malnutrition,head and neck cancer,environment history,homemade food, |
出版年 : | 2016 |
學位: | 碩士 |
摘要: | 營養在整個癌症病程中有相當的影響,並且需要及早介入監控。頭頸部腫瘤患者有因為物理性阻塞,而造成的特殊進食問題,以及功能上的缺失。釐清營養不良的相關因子和犬貓物種之間臨床表現和預後的差異,將有助我們辨認高風險的患者,進而助於臨床上的處置選擇,增進生活品質,以及延長存活時間。
評估腫瘤相關營養不良在國立台灣大學附設動物醫院動物癌症中心,初次就診頭頸部腫瘤患者的比例和風險因子。 單一研究單位,前瞻性研究。紀錄基本資料,腫瘤評估和餵食計畫。統計腫瘤相關營養不良的比例,並且使用卡方分析來評估風險因子。 蒐集2015年2月至2016年1月,為期一年的初診患者。頭頸部腫瘤佔21%(135/641)動物癌症中心初診患者,是第二常見腫瘤部位。28/76 (37%) 狗和 24/29 (83%) 貓在初次就診時有營養不良,物種之間發生的比例達到顯著差異(P<0.001)。營養不良在犬隻與腫瘤分期高度相關(P<0.001),但在貓卻缺乏此關聯。在貓,症狀與治療間隔有顯著相關(P = 0.001)。在狗,有高比例的鮮食餵食,並且和其他食物類型相比,鮮食有高比例的熱量攝取不足(P <0.001)。 頭頸部和其他部位相比,有高的營養不良比例。營養不良在貓常見,並且與腫瘤分期無關。但是在狗相對少見並且侷限在高腫瘤分期的患者。飼養環境有顯著的影響,鮮食飼養的犬隻,和多貓家庭,任食的貓都屬於高風險族群。辨認犬貓營養不良的危險因子將有助於我們預防營養不良的發生,以及選擇適當的醫療介入時機。 Nutrition has enormous effect on cancer management and early intervention is indispensable. Patients with head and neck cancer have unique oral feeding problem directly caused by physical obstruction and functional impairment of the tumor. Identifying factors associated with malnutrition, different clinical behavior and final outcome between dogs and cats would help clinicians to identify high-risk individuals, improving clinical treatment response, patient quality of life and ultimately patient survival. Our study objectives is to estimate the percentage and to identify malnutrition risk factors associated with malnutrition in canine and feline head and neck tumor patients attended at Animal Cancer Treatment Center (ACTC) of National Taiwan University Veterinary Hospital. This study is a single-center prospective study. Patient Signalment, tumor staging and feeding strategy were also recorded. Percentage of malnutrition was adjusted for the sampling approach. Chi-square test was used to identify factors associated with malnutrition. Study was conducted between February 2015 and January 2016. Head and neck cancer accounts for 21%(135/641) in all patients attending ACTC, which site is the second most common cancer location. 28/76 (37%) dogs and 24/29 (83%) cats were malnourished at the time of presentation. In dogs, there is strong association with cancer-related malnutrition and tumor stage (P<0.001). But the correlation was absent in cats. The duration of clinical signs prior to diagnostic approach and initial chief complain show strong association in cats (P = 0.001). Dogs have unique high percentage of home made diet feeding (36%) compared to cats (7%). But, compared to other food type, home made diet feeding has high proportion of insufficient calorie intake (P <0.001). Head and neck has higher percentage of cancer-related malnutrition compared to other location.37% Dogs and 83% cats had malnutrition at the time of presentation, which showed significant difference between species. The prevalence of cancer-related malnutrition among cats is high regardless of tumor stage, but is less common in dogs and always limited to higher tumor stage subgroup. Environment has tremendous effect on malnutrition. Homemade food feeding dogs and large family size with ad libitum feeding cats are high-risk population. The knowledge of identified risk factors for cancer-related malnutrition and species differences between dog and cat could help us prevent the occurrence and consider the proper timing and indication of advanced nutritional intervention. |
URI: | http://tdr.lib.ntu.edu.tw/jspui/handle/123456789/49540 |
DOI: | 10.6342/NTU201602558 |
全文授權: | 有償授權 |
顯示於系所單位: | 臨床動物醫學研究所 |
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