口服营养补充剂对乳腺癌术后化疗患者肠黏膜屏障功能及营养情况的影响  

Effects of oral enteral nutrition supplement on intestinal mucosal barrier function and nutritional status in patients with postoperative breast cancer undergoing chemotherapy

作　　者：薛姣 代建波 高海燕 杨方亮 吕国君 XUE Jiao;DAI Jianbo;GAO Haiyan;YANG Fangliang;LYU Guojun(Department of General Surgery,the Affiliated Changzhou No.2 People′s Hospital of Nanjing Medical University,Changzhou,Jiangsu 213000,China;Department of General Surgery,the Affiliated Changzhou No.4 People′s Hospital of Suzhou University,Changzhou,Jiangsu 213000,China)

机构地区：[1]南京医科大学附属常州第二人民医院普通外科,江苏常州213000 [2]苏州大学附属常州市第四人民医院乳腺外科,江苏常州213000

出　　处：《现代医药卫生》2022年第5期738-742,共5页Journal of Modern Medicine & Health

基　　金：黎介寿院士肠道屏障专项研究基金项目(LJS_201614)。

摘　　要：目的探讨口服营养补充剂对乳腺癌术后接受环磷酰胺联合表阿霉素贯序方案(EC-T)化疗对患者肠黏膜屏障功能及营养情况的影响。方法选取2019年12月至2020年12月南京医科大学附属常州第二人民医院收治的单侧乳腺癌术后接受EC-T化疗患者80例,分为研究组(接受口服营养补充剂)和对照组(常规饮食指导),每组40例。采用整体营养状况评估量表、尿乳果糖/甘露醇和血清二胺氧化酶实验室检测、临床随访和肠黏膜屏障功能及营养状况对比等,评价2组患者肠黏膜屏障功能及营养状况。结果研究组患者接受EC-T化疗首个疗程后腹泻发生率,以及尿乳果糖/甘露醇、血清二胺氧化酶检测值均明显低于对照组,差异均有统计学意义(P<0.05);营养情况稍好于对照组。2组患者化疗后恶心、呕吐、骨髓抑制、肝肾损伤等不良反应发生率比较,差异均无统计学意义(P>0.05)。结论乳腺癌术后接受EC-T化疗患者口服肠内营养相比普通饮食能有效保护患者肠黏膜屏障功能并改善其营养状况。Objective To investigate the effects of oral enteral nutrition supplement(ONS)on intestinal mucosal barrier function and nutritional status in postoperative breast cancer patients accepting epirubicin combined with cyclophosphamide chemotherapy time-sequentially(EC-T).Methods A total of 80 postoperative patients with unilateral breast cancer who received EC-T chemotherapy were included from the Affiliated Changzhou No.2 People′s Hospital of Nanjing Medical University from December 2019 to December 2020.The patients were divided into the experimental group(receiving oral nutritional supplements)and the control group(receiving routine dietary guidance),with 40 patients in each group.The method of the global nutritional status rating scale,urinary lactulose/mannitol(L/M)and serum diamine oxidase(DAO)detection,clinical follow-up and comparison of intestinal mucosal barrier function and nutritional status were used,the intestinal mucosal barrier function and nutritional status of the two groups were evaluated.Results This study showed that after receiving a course of EC-T chemotherapy,the incidence of diarrhea,urine L/M and serum DAO detection values of the experimental group were lower than those of the control group,with statistically significant differences(P<0.05),and the nutritional status of the patients was slightly better than that of the control group.However,there was no significant difference in the occurrence of nausea and vomiting,bone marrow suppression,liver and kidney injury(P>0.05).Conclusion Oral enteral nutrition can effectively protect intestinal mucosal barrier function and improve the nutrition status of postoperative breast cancer patients after EC-T chemotherapy compared with the normal diet.

关 键 词：口服肠内营养 乳腺肿瘤 手术后期间 联合药物疗法 肠黏膜屏障功能 营养评价 

分 类 号：R459.3[医药卫生—治疗学] R737.9[医药卫生—临床医学]