肠内营养支持对食管癌放疗患者营养状态和放射损伤的影响

Effects of enteral nutrition on the nutritional status and radiologic lesion of the patients with esophageal carcinoma radiotherapy

目的探讨经鼻十二指肠营养管置入术行肠内营养支持对食管癌放疗患者营养状态和放射损伤的影响。方法选取2015年6月至2016年12月于我院住院治疗的46例食管鳞癌放疗患者,随机分成营养组和常规组,每组23例。营养组患者在放疗前行经鼻十二指肠营养管置入术,并行营养支持。常规组患者放疗期间常规饮食。比较2组患者放疗前和放疗后各项营养学相关指标,评估2组患者急性放射性损伤的发生情况。结果营养组患者放疗前和放疗后血红蛋白、白蛋白、前白蛋白和体质量等营养学指标差异无统计学意义(P>0.05)。常规组患者放疗后营养学相关指标较放疗前降低,差异有统计学意义(P<0.05)。常规组患者放疗急性毒性反应重于营养组。结论经鼻十二指肠营养管置入术应用于食管癌放疗患者能有效改善营养状态,减轻放射损伤,且安全、方便,是值得临床推广的肠内营养干预途径。

Objective To analyze the effects of enteral nutrition through nasal duodenal nutrition tube on the nutritional status and radiologic lesion of the patients with esophageal carcinoma radiotherapy. Methods Forty-six patients with esophageal carcinoma radiotherapy in our hospital from June 2015 to December 2016 were selected as research subjects, and were randomly divided into the nutrition intervention group and the conventional group, each consisting of 23 patients. Before radiotherapy, the patients in the nutrition intervention group received duodenal nutrition tube surgery and had enteral nutritional support through the nasal duodenal nutrition tube, while the patients in the conventional group had routine diet during radiotherapy. Various nutritional indicators of the patients in the 2 groups were compared both before and after radiotherapy, and acute radiological lesion occurred in the patients of the 2 groups was eval-uated. Results For the patients of the nutrition intervention group, there was no statistical significance in such indicators as hemoglobin （Hb） , albumin （ALB） , prealbumin （PA） and body weight （WT） , when comparisons were made between pre-radiotherapy and post-radiotherapy （P 〉 0.05 ）. However, for the patients of the conventional group, nutrition-related indicators after radiotherapy were signifi-cantly decreased, as compared with those before radiotherapy（P 〈0. 05）. Acute radiological reaction for the patients of the conventional group was severer, as compared with that of the nutrition intervention group（P 〈0.05）. Conclusion The application of enteral nutri-tion support through nasal duodenal nutrition tube could effectively improve patient nutritional status, alleviate radiological lesion, and was safe and convenient, For this reason, it was worth further clinical extension.