Abstract:

Objective To assess the nutritional status of patients with oral intake following esophagectomy and to explore the influencing factors based on the health ecological model，so as to provide evidence for developing intervention strategies. Methods A convenience sampling method was used to recruit patients who had undergone radical esophagectomy and attended outpatient follow-up visits at a tertiary cancer hospital in Shanghai from December 2024 to September 2025. A total of 186 patients were enrolled. Nutritional status was assessed using the Patient-Generated Subjective Global Assessment（PG-SGA），and factors influencing nutritional status were analyzed. Results A total of 181 valid questionnaires were collected. Among the participants，30 patients（16.57%） were classified as well nourished or suspected of malnutrition；53 patients（29.28%） had moderate malnutrition；98 patients（54.14%） had severe malnutrition. Multivariate analysis showed that age，postoperative time，type of dietary，eating frequency，caloric intake，physical activity level，and mental health status were significant factors influencing nutritional status in patients with oral intake following esophagectomy（P<0.05）. Conclusion The incidence of moderate to severe malnutrition is high among patients with oral intake following esophagectomy，showing a phased distribution pattern. Age≥65 years，shorter postoperative duration，semi-liquid diet，low eating frequency，inadequate caloric intake，low physical activity，and the poorer mental health status are independent risk factors for malnutrition. Early identification of these risk factors and implementation of targeted nursing interventions are essential to reduce the risk of postoperative malnutrition.

Key words: Esophageal Neoplasms, Eating Behaviors, Nutritional Status, Root Cause Analysis, Nursing Care

摘要：

目的 调查食管癌术后经口进食患者的营养状况，并应用健康生态学模型探究其影响因素，为制订干预策略提供依据。方法 采用便利抽样法，选取2024年12月至2025年9月在上海市1所三级甲等肿瘤专科医院门诊复诊的186例食管癌根治术术后患者作为调查对象。使用患者主观整体营养状况评估工具以及人体成分、实验室指标评估食管癌术后经口进食患者的营养状况，并分析其影响因素。结果 最终纳入患者181例，其中营养良好或可疑营养不良30例（16.57%），中度营养不良53例（29.28%），重度营养不良98例（54.14%）。多因素分析结果显示，年龄、术后天数、饮食类型、饮食频率、热量摄入、体力活动水平、心理健康状况为食管癌术后经口进食患者营养状况的影响因素（P<0.05）。结论 食管癌术后经口进食患者中、重度营养不良发生率较高。年龄≥65岁、术后天数较短、半流质饮食、饮食频率低、热量摄入不达标、低体力活动水平、心理健康状况较差是营养不良的独立危险因素。医护人员应早期识别食管癌术后经口进食患者营养不良的危险因素，实施针对性的干预措施，从而降低术后营养不良的发生风险。

关键词: 食管肿瘤, 饮食行为, 营养状况, 影响因素, 护理