肠内营养对食管癌同期放化疗患者营养状况及不良反应的影响

Influence of enteral nutrition on nutritional status and adverse reactions in patients with esophageal carcinoma after concurrent chemoradiotherapy

目的分析肠内营养对食管癌同期放化疗患者营养状况的影响,并探讨对放化疗的不良影响。方法对75例食管癌同期放化疗患者给予不同的营养支持方式,其中肠内营养组患者43例,施行早期肠内营养+常规饮食;常规饮食组患者32例,早期予单纯的常规饮食,在放疗后期,由于不良反应影响进食时增加静脉营养。比较两组患者营养状况及不良反应。结果放疗前后,肠内营养组平均体重略有增加(0.64kg),血红蛋白升高6.38g/L,血清白蛋白升高1.63g/L,白细胞计数增加0.26×109/L;常规饮食组体重下降6.72kg,血红蛋白减少24.85g/L,血清白蛋白减少6.13g/L,白细胞计数减少1.86×109/L。两组比较,各营养指标差异均有统计学意义(P<0.05)。结论食管癌同期放化疗患者早期肠内营养安全有效,可以改善患者营养状况,提高机体的免疫力,保证治疗顺利完成。其不良反应可能与个体差异和化疗方案有关,在对此类患者护理时应加强个性化护理。

Objective To explore the influence ofenteral nutrition on nutritional status and adverse reactions in patients with esophageal carcinoma after concurrent chemoradiotherapy. Methods A total of 75 patients with esophageal cancer after concurrent chemoradiotherapy were divided into the experiment group （n=43） and the control group （n=32）. The patients in the experiment group received enteral nutrition and dietary care, while those in the con- trol group were given routine dietary care at the early stage and then parenteral nutrition because of influence from ad- verse reactions. The indexes of nutritiunal status （including body weight, hemoglobin, serum albumin, white blood cell count） and adverse reaction were compared between the two groups. Results After radiotherapy, the average body weight, hemoglobin, serum albumin, and white blood cell count in the experiment group were increased as compared with before radiotherapy （0.64 kg, 6.38 g/L, 11.63 g/L, 0.26 ×10VL, respectively）, and the indexes were decreased in the control group （6.72 kg, 24.85 g/L, 6.13 g/L, 1.86× 109/L, respectively）. The indexes after radiotherapy showed sta- tistically significant difference between the two groups （P〈0.05）. Conclusion Enteral nutrition is safe and effective for patients with esophageal carcinoma after concurrent chemoradiotherapy, which improves the nutritional status and immunity of patients. The adverse reactions may be related to individual difference and chemoradiotherapy, thus indi- vidual nursing care should be performed.