全程营养干预在腹腔脱落细胞学阳性胃癌病人转化治疗中的应用价值  

The application value of whole-course nutritional intervention in conversion therapy for gastric cancer patients with positive peritoneal lavage cytology

作　　者：丁平安 杨沛刚[1] 谢琪[2] 田园[1] 张志栋[1] 王冬[1] 檀碧波[1] 郭洪海[1] 刘洋[1] 李勇[1] 赵群[1] DING Ping-an;YANG Pei-gang;XIE Qi;TIAN Yuan;ZHANG Zhi-dong;WANG Dong;TAN Bi-bo;GUO Hong-hai;LIU Yang;LI Yong;ZHAO Qun(The Third Department of Surgery,the Fourth Hospital of Hebei Medical University,Shijiazhuang 050011,Hebei,China;Department of Nutrition,the Fourth Hospital of Hebei Medical University,Shijiazhuang 050011,Hebei,China)

机构地区：[1]河北医科大学第四医院外三科,河北石家庄050011 [2]河北医科大学第四医院营养科,河北石家庄050011

出　　处：《肠外与肠内营养》2021年第6期332-337,共6页Parenteral & Enteral Nutrition

基　　金：河北卫健委县级公立医院适宜卫生技术推广入库项目(2019024);政府资助临床医学优秀人才培养项目(2019012);河北省高等学校科学技术研究项目(ZD2019139)。

摘　　要：目的:探讨腹腔脱落细胞学阳性胃癌(P_(0)CY_(1))病人在进行腹腔内联合全身化疗(NIPS)转化治疗期间进行全程营养干预治疗的临床价值。方法:采用前瞻性研究方法,选取2019年10月至2020年10月河北医科大学第四医院外三科收治的符合入组条件的P_(0)CY_(1)病人,按1:1随机分为试验组(全程营养干预治疗+NIPS转化治疗组)和对照组(NIPS转化治疗组)。比较两组在转化治疗期间体质量及营养相关血液学指标变化情况、化疗结束后不良反应发生率、治疗完成率及近期疗效。结果:共入组68例P_(0)CY_(1)病人,经3周期NIPS转化治疗结束后试验组病人体质量、血清白蛋白、血清前白蛋白、血清总蛋白、PG-SGA评分均明显优于对照组(均P<0.05),但两组病人血红蛋白变化无差异(P>0.05)。试验组≥2级白细胞减少症和粒细胞减少症发生率明显低于对照组(P=0.004、0.028),同时转化治疗完成率高于对照组(P=0.040)。试验组DCR、ORR、FCC转阴率均优于对照组(P=0.031、0.024、0.028)。结论:对于P_(0)CY_(1)病人进行NIPS转化治疗期间进行全程营养治疗有利于改善病人营养状况,提高治疗完成率,降低不良反应。Objective:To investigate the clinical value of whole-course nutritional intervention in patients with peritoneal lavage cytology-positive gastric cancer(P_(0)CY_(1)) during the conversion therapy of neoadjuvant intraperitoneal and systemic chemotherapy(NIPS).Methods:A prospective research method was used to select P_(0)CY_(1) patients who were admitted to the third department of the fourth hospital of Hebei Medical University from October 2019 to October2020 and were randomly divided into the experimental group(enteral nutrition therapy+NIPS conversion treatment group)and control group(NIPS conversion treatment group)according to 1:1.The changes of body weight and nutritionrelated hematological indicators,the incidence of adverse reactions after chemotherapy,the completion rate of treatment and the short-term efficacy of the two groups during the conversion treatment were compared.Results:A total of 68P_(0)CY_(1) patients were enrolled.After 3 cycles of NIPS conversion treatment,the body weight,serum albumin,serum prealbumin,serum total protein,and PG-SGA scores of the patients in the experimental group were significantly better than those in the control group(all P<0.05),but there was no difference in hemoglobin changes between the two groups(P>0.05).The incidences of leukopenia and granulocytopenia in the experimental group≥2 grade was significantly lower than those in the control group(P=0.004,0.028),and the completion rate of conversion therapy was higher than that in the control group(P=0.040).The negative conversion rates of DCR,ORR and FCC in the experimental group were better than those in the control group(P=0.031,0.024,0.028).Conclusion:The whole-course nutritional therapy during NIPS conversion therapy for P_(0)CY_(1)patients is.beneficial to improve the nutritional status of patients,increase the treatment completion rate,and reduce adverse reactions.

关 键 词：胃肿瘤 腹腔脱落细胞学阳性 转化治疗 营养支持 

分 类 号：R735.2[医药卫生—肿瘤] R459.3[医药卫生—临床医学]