早期管饲营养支持在食管鳞癌同步放化疗中的临床应用  

Application of Early Tube Feeding Nutrition Support in Concurrent Radiotherapy and Chemotherapy of Esophageal Squamous Cell Carcinoma

作　　者：孟凡军[1] 王维浩 潘素明[1] 陈育标[1] 李灿新 李嘉斌 黄海鹏 邱波 MENG Fan-jun;WANG Wei-hao;PAN Su-ming;CHEN Yu-biao;LI Can-xin;LI Jia-bin;HUANG Hai-peng(Jieyang People’s Hospital,Jieyang,China,522000)

机构地区：[1]揭阳市人民医院,广东揭阳522000 [2]不详

出　　处：《食管疾病》2021年第4期291-295,共5页Journal of Esophageal Diseases

摘　　要：目的探讨在食管鳞癌同期放化疗患者中,早期管饲营养支持治疗是否优于常规营养支持治疗。方法本项目为随机对照、Ⅱ期研究,计划入组77例接受根治性同步放化疗的食管鳞癌患者,随机分为两组。观察组38例,放疗开始前开始管饲营养支持,每日营养摄入总量为30~35 kcal·kg^(-1);对照组39例,常规口服营养支持,每日营养摄入总量为30~35 kcal·kg^(-1);若患者总摄入量小于目标量60%超过5 d,可后期改为管饲营养支持或补充性肠外营养支持。观察体质量、血红蛋白、血清白蛋白、生活质量评分、治疗毒副反应、治疗效果等,以比较早期管饲营养支持与常规营养支持对改善患者的营养状况、减少不良反应、提高治疗效果的作用。结果放化疗前两组的基础营养状况差异无统计学意义(P>0.05),治疗后观察组患者营养状况优于对照组,差异有统计学意义(P<0.05),观察组治疗前后营养状况对比差异无统计学意义(P>0.05),对照组治疗前后营养状况对比差异有统计学意义(P<0.05)。3~4级急性放射性食管炎两组的对比,差异有统计学意义(P<0.05)。观察组治疗客观缓解率为84.21%,对照组为76.92%,但差异无统计科学意义(P>0.05)。结论食管鳞癌同期放化疗患者早期管饲营养支持治疗,可以有效地改善患者的营养状况,减轻严重不良反应,提高患者放化疗的耐受性和客观缓解率。Objective To investigate whether early tube feeding nutritional support therapy is better than conventional nutritional support therapy in patients with esophageal squamous cell carcinoma undergoing concurrent radiotherapy and chemotherapy.Methods 77 patients with esophageal squamous cell carcinoma undergoing radical concurrent radiotherapy and chemotherapy were randomly divided into 2 groups.In the observation group,38 cases received tube feeding nutritional support before radiotherapy,and the total daily nutritional intake was 30~35 kcal·kg^(-1);in the control group,39 cases received routine oral nutritional support,and the total daily nutritional intake was 30~35 kcal·kg^(-1),too;if the patient’s total intake is less than 60%of the target amount for more than 5 days,it can be changed to tube feeding nutritional support or supplementary parenteral nutritional support in the later stage.Body mass,hemoglobin,serum albumin,quality of life score,treatment toxicity and side effects and treatment effect were observed to compare the effects of 2 groups on improving patients’nutritional status,reducing adverse reactions and improving treatment effect.Results There was no significant difference in basic nutritional status between the two groups before radiotherapy and chemotherapy(P>0.05).After treatment,the nutritional status of the observation group was better than that of the control group,and the difference was statistically significant(P<0.05).Before and after treatment,the difference of nutritional status in control group was statistically significant(P<0.05).There was a statistically significant difference between the two groups of grade 3~4 acute radiation esophagitis(P<0.05).The objective remission rates were 84.21%in the observation group and 76.92%in the control group,but there is no significant difference between them(P>0.05).Conclusion Early tube feeding nutritional support therapy for esophageal squamous cell carcinoma patients with concurrent radiotherapy and chemotherapy can effectively improve the

关 键 词：早期 管饲 营养支持 食管癌 同期放化疗 

分 类 号：R735.1[医药卫生—肿瘤]