两种营养方式在鼻咽癌放疗患者营养干预中的对比研究

Comparison Study of Different Ways of Nutrition Intervention on Patients With Nasopharyngeal Carcinoma in Radiotherapy

目的探讨不同营养干预方法对放疗鼻咽癌患者的营养改善效果,为鼻咽癌放疗患者选择最佳的营养干预方式提供临床依据。方法选择2012-01/2014-06行放射治疗的鼻咽癌患者170例,随机分为鼻饲组和肠外营养组,鼻饲组患者在进食困难时留置胃管行肠内营养,肠外营养组患者在进食困难时给予静脉高营养支持治疗。比较两组患者在放疗前后血清白蛋白、血红蛋白、体重等营养指标及发生贫血、血小板降低、恶心呕吐等不良反应之间存在的差异。结果鼻饲组患者放疗后各项营养学指标明显好于肠外营养组(P<0.05)。鼻饲管组患者贫血、血小板降低、恶心呕吐、放射性皮炎的发生数显著低于肠外营养组(P<0.05),而口腔黏膜损害、口腔炎、吞咽痛和口干的发生数与肠外营养组相比无显著差异性(P>0.05)。结论营养鼻饲是鼻咽癌患者治疗过程中较好的营养支持方式,能够较好地改善患者的营养状况,降低不良反应发生率。

Objective To investigate the effects of different nutritional interventions on patients with nasopharyngeal carcinoma in radiotherapy,and to provide the clinical basis for nutritional intervention. Methods One hundred and seventy patients with nasopharyngeal carcinoma in radiotherapy were randomly divided into nasogastric group and parenteral group. The nasogastric group were received nasal feeding when they had eating difficulties,while parenteral group were received intravenous high nutritional support when they had eating difficulties.Comparing the differences of two groups before and after radiotherapy in nutrition indicators of serum albumin,hemoglobin,weight and others,and in adverse events of anemia,platelet reduce,nausea and vomiting. Results The nutrition indicators of nasogastric group were better than that of parenteral group（ P 〈0. 05）. The occurrence of anemia,platelets,nausea and vomiting,radioactive dermatitis in nasogastric group were statistically lower than that of parenteral group（ P〈0. 05）. However,compared with parenteral group,the occurrence of oral mucosa damage,stomatitis,swallowing pain and dry mouth in nasogastric group showed no statistical difference（ P 〉0. 05）. Conclusion Nasogastric nutrition can better improve the nutritional status of patients,reduce the incidence of adverse reactions. Therefore,nasogastric nutrition is a good way of nutritional support in the process of radiotherapy in patients with nasopharyngeal carcinoma.