结直肠癌病人根治术后家庭肠内营养支持的可行性及效果分析

Feasibility and effectiveness analysis of home enteral nutrition support in patients with colorectal cancer after radical surgery

目的:探究结直肠癌病人根治术后家庭肠内营养支持的可行性以及效果。方法:选取2017年7月到2018年10月期间已行结直肠癌根治术且出院时仍存在营养风险的65例病人作为研究对象,随机分为干预组34例与对照组31例。干预组病人出院后在常规居家饮食的基础上服用整蛋白型肠内营养粉,对照组病人出院后进食普通居家饮食。观察两组病人出院时及出院后第六周复查时体重、BMI、实验室生化营养指标等变化,观察营养对化疗的影响并进行生活质量评估。结果:复查时,干预组病人体重上升至(51.89±6.01)kg,对照组病人体重下降至(48.35±7.94)kg,差异有统计学意义(P <0.05);干预组病人总蛋白、前白蛋白、淋巴细胞水平、化疗进程、胃肠道副反应情况、膳食能量与蛋白质优于对照组,差异有统计学意义(P <0.05);生活质量评估中,干预组病人在情绪状况、失眠、腹泻以及整体健康/生活质量方面得分优于对照组,差异有统计学意义(P <0.05)。结论:有营养风险的结直肠癌病人进行家庭肠内营养支持可以改善病人的营养状况和生活质量,增加化疗的耐受性。

Objective: To investigate the feasibility and effect of home enteral nutrition(HEN)support in patients with colorectal cancer after radical surgery. Methods: From July 2017 to October 2018, 65 patients with colorectal cancer underwent radical resection and had nutritional risk at discharge were collected and randomly subjected into intervention group(n = 34) and control group(n = 31). After discharge, the intervention group received whole-protein enteral nutrition on the basis of regular diet, and the control group took only regular diet. Body weight, BMI, laboratory serum nutritional indicators at discharge and six weeks after discharge were compared, and the effects of nutrition on chemotherapy and quality of life were observed. Results: At the time of reexamination, the body weight of intervention group increased to(51.89 ± 6.01) kg, and the body weight of control group decreased to(48.35 ± 7.94) kg, the difference was statistically significant(P < 0.05). Total prorein, prealbumin, lymphocyte levels, chemotherapy progress、gastrointestinal side effects, dietary energy and protein were significantly better in the intervention group than in the control group(P < 0.05). the quality of life assessment showed that, emotional status, insomnia, diarrhea and overall health/quality of life in the intervention group were significantly better than those in the control group(P < 0.05).Conclusion: HEN for patients with colorecta cancer at nutritional risk may improve the nutritional status and quality of life of patients and increase the tolerance of chemotherapy.