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. |
[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. |