术前新辅助化疗结合肠内营养对胃癌患者肿瘤细胞增殖活性的影响效果分析  

Effect analysis of preoperative neoadjuvant chemotherapy combined with enteral nutrition to gastric cancer patients tumor cell proliferative activity

作　　者：裴进田 卢芸 阴炳侠 

机构地区：[1]唐山市乐亭县中医医院外科,河北唐山063000

出　　处：《空军医学杂志》2016年第5期326-329,共4页Medical Journal of Air Force

摘　　要：目的探讨术前新辅助化疗结合肠内营养对胃癌患者肿瘤细胞增殖活性的影响效果。方法将我院收治的132例进展期胃癌患者,随机分为2组,予以术前新辅助化疗联合肠内营养者为观察组,单纯予以新辅助化疗者为对照组,观察2组患者治疗前后的肿瘤细胞增殖活性、免疫水平以及营养状况的改善情况,评价焦虑及生活质量情况。结果治疗前,2组患者的肿瘤细胞增殖活性、免疫指标、营养状况差异均无统计学意义(P>0.05);治疗后,与对照组比较,观察组患者的CD4、CD4/CD8、自然杀伤细胞、总蛋白、清蛋白、前清蛋白、转铁蛋白、血红蛋白均明显增加,DI、SPF、PI、CD8、营养风险筛查评分明显降低,差异有统计学意义(P<0.05)。治疗前,2组患者的汉密尔顿焦虑量表(HAMA)评分总分、精神性因子以及躯体性因子分比较,差异无统计学意义(P>0.05);治疗后,与对照组比较,观察组患者的HAMA评分总分及各因子分均明显降低,差异具有统计学意义(P<0.05)。随访3、6个月观察组的生活质量指标生理机能、生理职能、情感职能得分均明显升高,差异具有统计学意义(p<0.01)。结论术前新辅助化疗结合肠内营养可较好地降低肿瘤细胞的增殖活性,改善其免疫水平及营养状况,降低其焦虑水平,提高生活质量。Objective To investigate the effect of preoperative neoadjuvant chemotherapy combined with enteral nutrition on the proliferative activity of tumor cellsin patients of gastric cancer. Methods 132 cases of progressive stage gastric cancer treated in our hospital were selected as chemotherapy combined with enteral nutrition group alone group （control group）. The proliferative activity subjects, who were randomly divided into preoperative neoadjuvant （observation group）, and preoperative neoadjuvant chemotherapy of tumor cells, immunity and nutritional improvement of the two groups were observed before and after therapy in addition to evaluation of their anxiety and quality of life. Results Before therapy, there was no difference in the proliferative activity of tumor cells, immunity indexes or nutrition between the two groups （P〉0.05）. After therapy, CD4, CD4/CD8, natural killer cells, total protein, albumin, prealbumin, TRF, and hemoglobin were obviously increased in the observation group patientsall compared with the control group, but DI, SPF, PI, CD8, nutritional risk screening scores obviously decreased. The difference was of statistical significance （P〈0.05） Before treatment, there was no statistically significant difference （P〉0.05） between the two groups in Hamilton Anxiety Scale （HAMA） scores, mental factorsor physical factors. After treatment, the total score of HAMA and each factor was significantly reduced in the observation group （P〈0.05）. The score of physical functioning, and emotional functioning was increased obviously in the observation group during the 3, 6 month follow-up. Conclusion Preoperative neoadjuvant chemotherapy combined with enteral nutrition can effectively decrease the proliferative activity of tumor cells; enhance the immunity and nutrition of patients, reduce their anxiety level, and improve their quality of life.

关 键 词：胃癌 进展期 新辅助化疗 肠内营养 肿瘤细胞增殖活性 免疫水平 营养 

分 类 号：R735.2[医药卫生—肿瘤]