进展期胰腺癌化疗中的肠外营养支持  

The application of the parenteral nutritional support in the advanced pancreatic carcinoma patients under chemotherapy

作　　者：刘建东[1] 才又红[2] 张绍东[2] 张军[2] 杨家祥[2] 

机构地区：[1]北京市普仁医院外科 [2]河北省邯郸市第一医院,016001

出　　处：《中国临床营养杂志》2001年第1期27-30,共4页Chinese Journal of Clinical Nutrition

摘　　要：目的　探讨进展期胰腺癌化疗中的肠外营养支持对病人营养、免疫状态及肿瘤疗效的影响。　方法　 33例病人均给予联合化疗 (FCMP/A) ,随机分为治疗组 (肠外营养 ) ,对照组 (常规治疗 )。检验两组病人的营养、免疫状态 ,肿瘤治疗的有效率、生存期。　结果　治疗组的前白蛋白、转铁蛋白、外周淋巴细胞总数、自然杀伤细胞活性、白介素I受体阳性细胞、生活质量评分、化疗药物毒性作用消失时间均优于对照组 (P <0 0 5或P <0 0 1)。减黄手术后化疗加营养支持的生存时间平均11 5个月 ,长于非减黄术者 (P <0 0 5 )。　结论　肠外营养支持可有效干预化疗药物消化道副反应所导致的营养状况下降 ,提高机体免疫力 ,改善生活质量 ,减黄术后化疗加营养支持能延长生存期。Objectives To explore the effects of parenteral nutrition on advanced pancreatic carcinoma patients under chemotherapy. Methods From Jun. 1995 to Jun. 1998, we treated 33 cases of advanced pancreatic carcinoma with combined chemotherapy. of which, 21 cases had histologically documented and 12 cases had exfoliative cytologically documented adenocarcinoma of the pancreas. Clinical staging: Ⅲ 26 cases, Ⅳ 7 cases. Thirty three cases of advanced pancreatic carcinoma patients were randomly divided into 2 groups. (1)treatment group (2) control group. The two groups received combined chemotherapy. The regimen was 5 FU+CF+MMC+DDP or EPI. The control group, 9 men and 6 women had a median age of 603 years, received combined chemotherapy and routine treatment; and the treatment group, 11 men and 7 women had a median age of 59.5 years,received the parenteral nutritional support for mean 128 days in the combined chemotherapy period. Results Treatment group was superior to control group. Serum prealbumin, transferrin concentration, total lymphocyte count, natural killer cells activity and IL-2R+cells (CD 25)percentage of peripheral blood increased significantly (P<005,P<001,P<005,respectively). However, no significant difference was observed in the respone rate (CR+PR) and the median swrvival time between the two groups. But after biliary drainage operation, received chemotherapy and TPN, the patients survival time increasad significantly. Conclusions The parenteral nutrition support was effective in maintaining the nutritional and immune status in the advanced pancreatic carcinoma petients receiving chemotherapy.

关 键 词：化疗 营养支持 胰腺癌 免疫 治疗 

分 类 号：R735.9[医药卫生—肿瘤]