鼻咽癌患者同步放化疗期间营养状况变化及其营养支持治疗的影响  

Nutritional status assessment and effect of nutritional intervention during concurrent radiochemotherapy for locally advanced nasopharyngeal carcinoma patients

作　　者：崔巍[1] 韩磊[1] 

机构地区：[1]山东济宁医学院附属医院肿瘤科,山东济宁272019

出　　处：《中华肿瘤防治杂志》2011年第18期1466-1469,共4页Chinese Journal of Cancer Prevention and Treatment

基　　金：山东省高层次卫生科技人才海内外培训专项经费自助〔鲁卫科教国合发(2007)10号〕

摘　　要：目的:探讨局部晚期鼻咽癌治疗期间营养指标变化,便于提前采取干预措施,增加营养,保证疗效。方法:2010-01-2010-10收集48例初治局部晚期鼻咽癌患者的临床资料,全部患者均接受同步放化疗,治疗期间观察体质量(W)、血红蛋白(Hb)、总蛋白(TP)、白蛋白(ALB)以及营养干预后相关指标的变化,将患者分为未营养干预组(A组)和营养支持组(B组),分析营养干预对营养指标变化的影响。结果:48例患者全部按照计划完成治疗,中位同期化疗3个周期。全部患者均在治疗过程中体质量随放化疗时间逐渐下降,第4周是体质量下降的拐点,A组和B组患者体质量变化差异明显,P<0.05。营养干预后B组患者体质量下降得到抑制。患者血红蛋白在放化疗第4、7周与初始对比差异有统计学意义,P<0.000 1。放化疗第4、7周总蛋白特别是白蛋白下降显著(P<0.000 1),而A组和B组对比,总蛋白和白蛋白的下降差异无统计学意义,P>0.05。结论:鼻咽癌同步放化疗期间营养状况明显下降,及时给予营养干预可减少体质量下降,对于完成治疗保证疗效具有重要意义。营养干预应作为局部晚期鼻咽癌综合治疗中的重要组成部分。OBJECTIVE： To discuss the change of nutrition indices during concurrent radiochemotherapy in locally advanced nasopharyngeal carcinoma patients and the influence of intervention, to improve nutrition level and guarantee effectiveness. METHODS： From January to October of 2010, clinical data of initial treatment in 48 locally advanced nasopharyngeal carcinoma patients were collected, and all patients accepted concurrent radiochemotherapy. Weight （W）, Hemoglobin （ Hb）, total protein （TP）, albumin （Alb） were observed weekly. Nutrition intervention were given in partial of patients with weight lost rapidly . Single variance analysis was used to assess the change of nutrition indices and the nutrition intervention. RESULTS： Forty-eight patients completed concurrent radiochemotherapy. The median concurrent radioehemotherapy was 3 cycles. It was decreasing with treatment in weight of 48 patients. The 4th week of radiochemotherapy was inflection point. Part of patients whose weigh lost more quickly was given nutrition intervention. The difference of weight lost between nutrition intervention group （A） and no nutrition intervention group （B） was significant（P〈0.05）. Weight decreasing of B after nutrition intervention was inhibited. To contrast with the initial status, the loss of hemoglobin, TP and Alb in the 4th week and the 7th week were all statistic different（P〈0. 000 1）. However, there was no significant difference in the loss of TP and Alb between A and B （P〉 0.05）. CONCLUSIONS： The nutrition indices of patients with locally advanced nasopharyngeal carcinoma were decreasing during concurrent radiochemotherapy. Nutrition intervention in time can restrain loss of weight, improve quality of life. Nutrition intervention should be im portant in comprehensive treatment of nasopharyngeal carcinoma.

关 键 词：鼻咽肿瘤 同步放化疗 体质量下降 营养干预 

分 类 号：R739.63[医药卫生—肿瘤]