全程营养支持治疗对局部晚期鼻咽癌患者营养状况的影响

Effect of Whole-course Nutrition Support on Nutritional Status of Patients with Locally Advanced Nasopharyngeal Carcinoma

目的探讨全程营养支持治疗对局部晚期鼻咽癌患者营养状况的影响。方法选取90例初治局部晚期鼻咽癌患者,随机分为实验组(全程营养支持治疗+同步放化疗)45例和对照组(同步放化疗)45例。运用PG-SGA评分、体格测量、血液学指标和急性放射反应,观察两组患者营养状况的变化,分析全程营养支持对营养状况的影响。结果放疗第2周后,对照组PA、Hb已明显下降,且Hb明显低于实验组;放疗第4周后,对照组体重明显低于放疗前,实验组体重和BMI明显优于对照组。放疗第4周后,对照组TP、ALB和PA显著低于实验组。放疗结束后,对照组PG-SGA评分及重度营养不良发生率均显著高于实验组。对照组骨髓抑制、口腔黏膜炎、吞咽困难或疼痛的分级程度明显高于实验组。结论全程营养支持治疗可显著减缓患者体重下降,减缓营养相关血液学指标的持续降低,减轻急性放射反应,能有效改善局部晚期鼻咽癌患者的营养状况,降低营养不良发生率。

Objective To investigate the effect of whole-course nutrition support on nutritional status of patients with locally advanced nasopharyngeal carcinoma(NPC).Methods We randomly divided 96 locally advanced NPC patients into the experimental group(whole-course nutrition support combined concurrent chemoradiotherapy,n=45)and the control group(only concurrent chemoradiotherapy,n=45).PG-SGA questionnaire,the anthropometry measurements,hematological indexes and acute radiology reactions were used to observe the nutritional status of NPC patients and analyzed the effect of whole-course nutrition support on nutritional status.Results PA and Hb of control group were significantly declined and Hb was significantly lower than that of the experimental group at the 2nd week of radiotherapy.At the 4th week of radiotherapy,the weight of control group were significantly lower than that before radiotherapy,and the weight,BMI,TP,ALB and PA of the experimental group were higher than those in control group.PG-SGA score and the incidence of severe malnutrition of control group were significantly higher than those of the experimental group at the end of radiotherapy.The grading of myelosuppression,oral mucositis and dysphagia of control group were significantly higher than those of the experimental group during radiotherapy.Conclusion Whole-course nutrition support can significantly retard the weight loss and the sustained decline in hematological indexes,reduce the acute radiation reactions,and then effectively improve the nutritional status and reduce the incidence of severe malnutrition of locally advanced NPC patients.