经鼻胃管肠内喂养对食管癌患者放化疗期间营养状况及身体状态的影响  

Effects of enteral feeding through nasogastric tube on nutritional status and body status of patients with esophageal cancer during radiotherapy and chemotherapy

作　　者：程艳莉 王苗苗 钟慧娟 陈莺歌 袁高峰 Cheng Yanli;Wang Miaomiao;Zhong Huijuan;Chen Yingge;Yuan Gaofeng(Department of Thoracic and Cardiac Surgery,the First People's Hospital of Suqian,Nanjing Medical University,Suqian 223800,Jiangsu,China;Department of Oncology,Suqian Hospital,Nanjing Gulou Hospital Group,Suqian 223800,Jiangsu,China;Department of Oncology,the First People's Hospital of Suqian,Nanjing Medical University,Suqian 223800,Jiangsu,China)

机构地区：[1]南京医科大学附属宿迁第一人民医院胸心外科,江苏宿迁223800 [2]南京鼓楼医院集团宿迁医院肿瘤科,江苏宿迁223800 [3]南京医科大学附属宿迁第一人民医院肿瘤科,江苏宿迁223800

出　　处：《肿瘤代谢与营养电子杂志》2024年第4期553-558,共6页Electronic Journal of Metabolism and Nutrition of Cancer

基　　金：江苏省“六大人才高峰”高层次人才选拔培养资助项目(WSW-302)。

摘　　要：目的探讨经鼻留置胃管管饲(NGT)对食管癌患者放化疗期间营养状况及身体状态的影响。方法回顾性分析2020年1月至2023年12月南京医科大学附属宿迁第一人民医院收治的100例行同步放化疗的食管癌患者,按照营养治疗方法不同分为2组,分别接受NGT肠内喂养组(n=50)和口服营养补充(ONS)组(n=50)。比较两组患者干预8周前后的营养状态[营养风险筛查2002(NRS 2002)、患者主观整体评估(PG-SGA)、体质指数(BMI)及相关血清营养指标]、身体状态[Karnofsky功能状态(KPS)评分及放化疗不良反应发生率]。结果干预前两组NRS 2002、PG-SGA和KPS评分比较,差异无统计学意义(P>0.05);干预8周后NGT组NRS 2002及PG-SGA评分明显低于ONS组,而KPS评分明显高于ONS组(P<0.05)。干预前,两组患者血清营养指标水平比较,差异无统计学意义(P>0.05);干预8周后,NGT组血清白蛋白、血红蛋白、铁及前白蛋白水平明显高于ONS组(P<0.05)。两组患者放化疗期间的不良反应发生率比较差异均无统计学意义(P>0.05)。结论对接受放化疗的食管癌患者而言,早期NGT能有效改善患者的营养状况,提高身体状态,临床应用价值良好。Objective To investigate the effects of intranasal feeding(NGT)through nasogastric tube on nutritional status and body status of patients with esophageal cancer during radiotherapy and chemotherapy.Method Retrospective analysis was performed on 100 patients with esophageal cancer who underwent concurrent chemoradiation and chemotherapy treated in the First People's Hospital of Suqian Affiliated to Nanjing Medical University from January 2020 to December 2023.They were divided into 2 groups according to different nutritional therapy methods.The nutritional therapy methods were NGT enteral feeding(n=50)and oral nutritional supplements(ONS)(n=50).The nutritional status(NRS 2002)and patient-generated subjective global assessment(PG-SGA)of the two groups were compared before and after 8 weeks of intervention assessment(PG-SGA),body mass index(BMI)and related serum nutritional indices],body status[Karnofsky performance status(KPS)and incidence of toxic side effects of chemoradiotherapy].Result There was no significant difference in the scores of NRS 2002,PG-SGA and KPS between the two groups before intervention(P>0.05).After 8 weeks of intervention,the scores of NRS 2002 and PG-SGA in NGT group were significantly lower than those in ONS group,while the scores of KPS in NGT group were significantly higher than those in ONS group(P<0.05).Before intervention,there was no significant difference in serum nutritional indexes between the two groups(P>0.05).After 8 weeks of intervention,serum ALb,Hb,Fer and prealbumin levels in NGT group were significantly higher than those in ONS group(P<0.05).There was no significant difference in the incidence of toxicity and side effects between 2 groups(P>0.05).Conclusion Early NGT nutritional support can effectively improve the nutritional status and physical status of patients with esophageal cancer receiving radiotherapy and chemotherapy,and has good clinical application value.

关 键 词：经鼻胃管肠内喂养 食管癌 营养状况 身体状态 营养风险筛查2002 患者主观整体评估 体质指数 放化疗 

分 类 号：R735.1[医药卫生—肿瘤] R459.3[医药卫生—临床医学]