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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.

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