网站首页期刊介绍通知公告编 委 会投稿须知电子期刊广告合作联系我们
最新消息:
营养预康复在食管癌患者放化疗期间的应用研究
作者:于佳妮1  唐媛媛1  曾珊2  裴忠玲1  葛小林1  徐露2 
单位:1. 南京医科大学第一附属医院 放疗科, 江苏 南京 210029;
2. 南京医科大学第一附属医院 营养科, 江苏 南京 210029
关键词:食管癌 放疗 同步放化疗 营养预康复 营养风险 并发症 
分类号:R473
出版年·卷·期(页码):2021·49·第二期(193-198)
摘要:

目的:探讨食管癌患者接受放疗或同步放化疗期间营养预康复应用效果。方法:选择我院放疗科2017年01月~2019年12月收治的102例存在营养不良风险的食管癌患者,采用随机数字表法分为对照组和研究组,每组51例。对照组执行传统饮食方案,研究组执行以安素为支持物的营养预康复方案。对比两组患者首次放疗或同步放化疗开始和放疗或同步放化疗结束的营养整体评估(Scored Patient-Generated Subjective Global Assessment,PG-SGA)评分、营养指标(body mass index,albumin,prealbumin,total serum protein,total lymphocyte count,BMI、ALB、PA、TP、TLC水平)检测、并发症发生情况及生活质量评分(KPS)。结果:在放疗或同步放化疗结束时,采用营养预康复方案的研究组相关的PG-SGA评分及营养指标的变化与对照组相比差异均有统计学意义。放疗或同步放化疗结束时,研究组PG-SGA评分变化显著低于对照组(t=12.132,P<0.001)。对照组放疗或同步放化疗结束后的BMI、ALB、PA、TP、TLC水平显著低于研究组,差异均有统计学意义(P<0.05)。治疗后研究组相关并发症发生率(为9.80%)明显低于对照组的25.49%(χ2=4.317,P=0.038);研究组放疗或同步放化疗结束后的KPS评分变化明显高于对照组,差异具有统计学意义(t=-12.17,P<0.001)。结论:食管癌患者放疗和同步放化疗期间应用营养预康复,能明显改善患者营养不良程度和相关指标,降低治疗并发症发生率,提高患者生存质量。

Objective:To investigate the effect of nutritional pre-rehabilitation on patients with esophageal cancer during radiotherapy and concurrent chemoradiotherapy. Methods: 102 patients with esophageal cancer who were at risk of malnutrition were selected from the radiotherapy department of our hospital from January 2017 to December 2019. They were randomly divided into the control group and the study group, with 51cases in each group. The control group performed a traditional diet program, and the study group performed a nutritional pre-rehabilitation program with ansuline as a support. We compared the nutritional holistic assessment(PG-SGA), nutritional index detection(BMI, ALB, PA, TP, TLC level), complications and life(KPS) of the two groups at the beginning of radiotherapy or the beginning or end of concurrent radiochemotherapy. Results: At the end of radiotherapy or concurrent radiochemotherapy, the PG-SGA scores and nutritional indicators of the study group were distinctly different from those of the control group. We found that the PG-SGA scores of the study group was markedly lower than control group when the patients finished the radiotherapy or concurrent radiochemotherapy,and the difference was statistically significant(t=12.132, P<0.001). The BMI, ALB, PA, TP, and TLC levels of the control group after the end of radiotherapy or concurrent radiochemotherapy were significantly lower than those of the study group (P<0.05). The incidence of complications after treatment in the study group(9.80%) was significantly lower than that in the control group(25.49%) (χ2=4.317, P=0.038).The difference of the KPS scores between the two groups after radiotherapy or concurrent radiochemotherapy. The KPS scores of the study group after radiotherapy or concurrent radiochemotherapy were evidently higher than those of the control group(t=-12.17, P<0.001). Conclusion: The use of nutritional pre-rehabilitation during radiotherapy and concurrent chemoradiotherapy in patients with esophageal cancer could obviously improve the malnutrition and indicators of patients, reduce the complications of treatment and optimize the quality of life.

参考文献:

[1] 施靖华.肿瘤病人的营养支持[J].国外医学肿瘤学分册, 2020,14(4):219-221.
[2] 任杰,袁志,张欣平,等.头颈部肿瘤患者放疗期间营养状况与生活质量现状及二者相关性分析[J].解放军医药杂志,2018,30(7):18-21.
[3] 王金宁,朱晓萍,邱昌翠.消化道恶性肿瘤患者营养评估工具的研究进展[J].中华现代护理杂志,2020,26(2):276-280.
[4] 向运莲,曾小梅.集束化营养干预方案对食管癌同步放化疗患者生活质量和营养状况的影响[J].实用临床医药杂志,2017,21(4):29-32.
[5] 吴蓓雯.恶性肿瘤患者营养不良诊断与治疗策略的研究进展[J].上海护理,2017,17(2):5-8.
[6] 付佳,唐磊,李子禹,等.CT区分Siewert Ⅱ型食管胃结合部腺癌cT3与cT4a:国际抗癌联盟/美国癌症联合委员会(UICC/AJCC)第8版分期与国际胃癌协会(IGCA)第4版分期对照研究[J].中华胃肠外科杂志,2018,21(9):1013-1018.
[7] 朱玉茹.肠内营养粉剂治疗苯丙酮尿症患儿的疗效和安全性分析[J].当代医学,2019,25(17):58-60.
[8] 李双燕,丁轶,冯金象,等.消化道恶性肿瘤患者营养状况分析及生活质量相关性研究[J].实用癌症杂志,2019,34(02):111-114.
[9] 程春来,李辉.胃肠道肿瘤患者围化疗期营养状况的评价及对免疫功能的影响[J].现代肿瘤医学,2015,23(10):1412-1416.
[10] 刘晓滨,祁丽,徐军,等.ⅠB~Ⅲ期胃癌术后患者同步放化疗和单纯化疗的疗效研究[J].实用癌症杂志,2016,31(10):1659-1661.
[11] 朱明炜,韦军民,陈伟,等.恶性肿瘤患者住院期间营养风险变化的动态调查[J].中华医学杂志,2018,98(14):1093-1098.
[12] 汪婷,龙小丽.食管癌患者围放化疗期营养不良的影响因素Logistic回归分析及其强化营养干预措施[J].实用临床医药杂志,2018,22(14):44-47.
[13] 杨丽萍.头颈部恶性肿瘤患者放化疗期间营养干预的研究进展[J].肿瘤学杂志,2018,24(9):861-865.
[14] 程国威,孙莉,张涛,等.不同营养支持方式对食管癌放疗患者影响[J].中华放射肿瘤学杂志,2019,28(7):505-508.
[15] 董高悦,许勤,孟爱凤,等.综合干预治疗在食管癌病人术后早期肠内营养耐受性及机体康复的研究[J].肠外与肠内营养,2017,24(3):146-149.
[16] 丛明华,李淑娈,刘雪辉,等.营养咨询联合口服营养补充对食管癌放疗患者临床结局的影响[J].中华临床营养杂志,2016,2(24):86-90.
[17] 马艳会,白献红,范雪莉,等.追踪护理模式对食管癌放疗患者营养状况的影响[J].中华现代护理杂志,2017,23(4):493-496.
[18] 明坤秀,程璐璐,程小韵,等.早期营养支持治疗和护理干预对食管癌术后胃肠功能的影响研究[J].中华肿瘤防治杂志,2016,23(Supp1):295-296.

服务与反馈:
文章下载】【发表评论】【查看评论】【加入收藏
提示:您还未登录,请登录!点此登录
您是第 458640 位访问者


 ©《现代医学》编辑部
联系电话:025-83272481;83272479
电子邮件: xdyx@pub.seu.edu.cn

苏ICP备09058541