食管癌患者放化疗期间合并恶性食管瘘的营养干预

Validity of Nutritional Intervention in Esophageal Cancer Patients with Both Malignant Fistula and Radiochemotherapy

目的：探讨营养支持干预对放化疗期间恶性食管瘘患者预后的影响。方法：回顾分析2010年1月-2012年12月本科收治的40例食管癌合并恶性食管瘘患者，总结营养干预方法、瘘管愈合情况及放化疗副反应发生情况。结果：40例患者中，32例瘘管闭合，6例未闭合予出院定期复查，2例死亡；放化疗治疗期间，副作用大多数为1~2级，8例出现3级及以上的呕吐，11例出现3级及以上的中性粒细胞减少，13例出现3级及以上的咳嗽。结论：营养风险筛查和肠内营养支持能有效提高食管癌合并恶性食管瘘的患者对放化疗的耐受性，完成相关治疗，并促进瘘口的愈合，值得在临床推广。

Objective：To investigate the validity of nutrition risk screening and enteral nutrition support for esophageal cancer patients with malignant fistula.Method：40 esophageal squamous cell carcinoma patients with malignant fistula were reviewed from January 2010 to December 2012,and nutrition risk screening approach,nutrition support, toxicity of radiochemotherapy and fistula closure were analyzed.Result：Of 40 patients,32 had completely fistula closure after the treatment,6 had no fistula closure and 2 died of massive bleeding. Grade 3 vomiting was observed in 8 out of 40 patients,grade 3 neutropenia occurred in 11 out of 40 patients,and grade 3 cough was recorded in 13 out of 40 patients. Conclusion：Nutrition risk screening and enteral nutrition support for esophageal squamous cell carcinoma patients with malignant fistula can improve patients’tolerance of radiochemotherapy to help patients finish the treatment,and promote fistula closure,which can be applied in clinical work.