结直肠癌患者术后营养状况调查及放化疗耐受性的影响因素分析

Survery on Postoperative Nutriture of Colorectal Cancer Patients,and Analysis on the Factors Influening Their Tolerance to Radio-chemotherapy

为调查结直肠癌患者术后营养状况,并分析影响放化疗耐受性的危险因素,回顾100例接受腹腔镜结直肠癌根治术且术后放化疗治疗的患者资料,患者放化疗前1周均应用营养风险筛查表(NRS2002)进行营养状况评估,分析术后放化疗耐受性与患者性别、年龄、肿瘤部位、分期、分化程度、患者营养状况、不良反应情况、KPS评分、白蛋白(Alb)及前白蛋白(PAB)水平等的相关性。结果显示,本组22例患者放化疗耐受性差,因毒副反应而终止放化疗,其余78例耐受性良好;54例NRS2002评分≥3分(有营养不良风险)。单因素分析显示,放化疗耐受性与患者NRS2002评分、不良反应分级、KPS评分有关,P<0.05。多因素分析显示,NRS2002评分<3分为结直肠癌术后放化疗耐受性的保护因素(P<0.05),不良反应分级≥Ⅲ级为结直肠癌术后放化疗耐受性的危险因素(P<0.05)。结果表明,结直肠癌患者术后大多存在营养不良状况,而营养不良直接影响放化疗耐受性,积极营养支持、控制不良反应对于保障患者放化疗顺利进行具有积极意义。

This study was to investigate postoperative nutriture of colorectal cancer patients,and to analyse risk factors influencing their tolerance to radio-chemotherapy,reviewed 100 cases’data who had all received radio-chemotherapy after radical surgery for colorectal cancer:1 week before radio-chemotherapy their tolerance to radio-chemotherapy with age,gender,neoplasm’s sites,staging,differentiation degree,patients’s nutriture,unward reaction status,KPS score ratings,as well as the levels of A1 band PAB,etc.As results,among the 100 cases,22 had bad tolerance,even due to unward reaction to stop radio-chemotherapy,rest 78 being good;54 cases’NRS2002 ratings≥3 points(i.e,inanition risk showing).Univariate analysis showed tolerance was related to patients’s NRS 2002 ratings,unward reaction classes,KPS ratings(P<0.05);Multi-variate analysis showed NRS 2002 ratings<3 points were protection factors on tolerance(P<0.05),while unward reaction classes≥Ⅲclass were risk factors on tolerance(P<0.05).Results show that most colorectal cancer patients are in inanition situation which then directly influence tolerance to radio-chemotherapy,thus giving active nutrition support and controlling unward reaction have active significance for securing radio-chemotherapy smoothly implemented.