肠内营养对老年胸腹腔镜食管癌根治术患者术后化疗不良反应和营养状况的影响分析  

Analysis of the effects of enteral nutrition on postoperative adverse reactions of chemotherapy and nutritional indexes in elderly patients undergoing thoracic laparoscopic radical resection of esophageal carcinoma

作　　者：吴艳[1] 张海平[1] 康晓艳[1] 周叶[1] 常海霞[2] Wu Yan;Zhang Haiping;Kang Xiaoyan;Zhou Ye;Chang Haixia(Department of Thoracic Surgery,the First Affiliated Hospital of Xinjiang Medical University,Urumqi 830054,China;Department of Nursing,the Fifth Affiliated Hospital of Xinjiang Medical University,Urumqi 830011,China)

机构地区：[1]新疆医科大学第一附属医院胸外科,乌鲁木齐830054 [2]新疆医科大学第五附属医院护理部,乌鲁木齐830011

出　　处：《中国医学前沿杂志（电子版）》2020年第10期100-104,共5页Chinese Journal of the Frontiers of Medical Science(Electronic Version)

基　　金：新疆维吾尔自治区自然科学基金项目(2017D01C277)。

摘　　要：目的分析肠内营养对老年胸腹腔镜食管癌根治术患者术后化疗不良反应和营养状况的影响。方法选择新疆医科大学第一附属医院2017年8月至2019年4月收治的85例老年食管癌患者为研究对象,按照随机数字表法将其分为研究组(44例)和对照组(41例)。所有患者均接受胸腹腔镜食管癌根治术治疗,术后接受多西他赛注射液+顺铂化疗,对照组患者于化疗第1天接受营养宣教和饮食建议,研究组患者于化疗第1天接受肠内营养支持治疗,直至化疗结束。比较两组患者化疗前和化疗结束时营养指标、生活质量评分和化疗期间不良反应发生情况。结果对照组患者化疗前和化疗结束时总蛋白、白蛋白、前白蛋白水平、体质指数、生活质量评分均显著低于本组化疗前(均P<0.05),整体营养状况主观评估(patientgenerated subjective global assessment,PG-SGA)评分显著高于本组化疗前(P<0.05);研究组患者化疗前和化疗结束时营养指标和生活质量评分比较差异均无统计学意义(均P>0.05)。研究组患者化疗结束时总蛋白、白蛋白、前白蛋白水平和体质指数均显著低于对照组(均P<0.05),PG-SGA评分和生活质量评分均显著高于对照组(均P<0.05)。研究组患者化疗期间食欲下降、消瘦、疲乏、腹泻、恶心/呕吐发生率均显著低于对照组(均P<0.05),两组患者脱发发生率比较差异无统计学意义(P>0.05)。结论肠内营养能够改善老年胸腹腔镜食管癌根治术患者术后化疗期间的营养状况,减少化疗不良反应,提高患者生活质量。Objective To analyze the effects of enteral nutrition on postoperative adverse reactions of chemotherapy and nutriti onal indexes in elderly patients undergoing thoracic laparoscopic radical resection of esophageal carcinoma.Method From August 2017 to April 2019,85 elderly patients with esophageal cancer admitted to the First Affiliated Hospital of Xinjiang Medical University were selected as the research objects and divided into research group(44 cases)and control group(41 cases)according to the random number table method.All patients received thoracic laparoscopic radical resection of esophageal cancer and docetaxel injection plus cisplatin chemotherapy was accepted after operation.Control group patients received nutritional education and dietary advice on the first day of chemotherapy,while patients in research group were given enteral nutritional support on the first day of chemotherapy,until the end of chemotherapy.The nutritional indexes,quality of life before and after chemotherapy,and adverse reactions during chemotherapy were compared between the two groups.Result The levels of total protein,albumin,prealbumin,body mass index and the scores of quality of life in control group before and after chemotherapy were significantly lower than those before chemotherapy(all P<0.05),while the scores of patient-generated subjective global assessment(PG-SGA)were significantly higher than those before chemotherapy(P<0.05).There were no significant differences in nutrition index and quality of life score before and after chemotherapy in the research group(all P>0.05).At the end of chemotherapy,the levels of total protein,albumin,prealbumin and body mass index in research group were significantly lower than those in control group(all P<0.05),while PG-SGA score and the scores of quality of life were significantly higher than those in control group(all P<0.05).The incidence of loss of appetite,emaci ation,fatigue,diarrhea and nausea/vomiting in research group during chemotherapy were significantly lower than those in cont

关 键 词：老年 胸腹腔镜食管癌根治术 肠内营养 术后化疗 不良反应 营养指标 

分 类 号：R735.1[医药卫生—肿瘤]