营养支持对白血病化疗患者营养状况及不良反应的影响

Effects of Enteral Nutrition Support on Nutritional Status and Adverse Reactions of Patients with Leukemia Chemotherapy

目的:观察和分析肠内营养支持对白血病患者在化疗时的营养状况和不良反应的影响。方法:选取青岛市中心医院2016年1月—2017年12月收治的白血病患者380例为研究对象,并随机分为观察组192例和对照组188例,两组患者均采用WDPAP方案化疗,同时给予观察组肠内营养支持,化疗时间为4w。观察和比较两组化疗期间或化疗后营养状况和不良反应情况。结果:观察组患者总蛋白、前白蛋白、视黄醇结合蛋白等指标明显高于对照组(P<0.01),观察组的三角肌皮皱厚度和上臂围测量值也明显高于对照组(P<0.05或P<0.01),观察组血小板和血红蛋白最低值明显高于对照组(P<0.05),但粒细胞缺乏症持续时间明显短于对照组(P<0.01),化疗期间观察组恶心呕吐、腹泻和黏膜炎等并发症发生率明显少于对照组(P<0.01)。结论:肠内营养支持能有效改善白血病化疗患者的营养不良状况,增强机体血液系统的化疗耐受能力和降低不良反应,可在临床推广使用。

[Objective] To observe and analyze the effects of enteral nutrition support on the nutritional status and adverse reactions of leukemia patients during chemotherapy. [Method] We selected 380 cases of leukemia patients admitted to our hospital from January 2016 to December 2017, and the patients were randomly divided into observation group 192 and control group 188. Both groups were treated with WDPAP chemotherapy, at the same time, the observation group enteral nutrition support, the chemotherapy time was 4 weeks. The nutritional status and adverse reactions of the two groups were observed and compared. [Result] The total protein, serum proalbumin and retinol binding protein were significantly higher in the observation group than in the control group （P 〈0.01 ）, and the deltoid skin wrinkle thick- ness and upper arm circunfference measurements of the observation group were also significantly higher than that in the control group （P 〈0. 05 or P 〈0.01 ） . The lowest values of platelets and hemoglobin in the observation group were significantly higher than those in the control group （P 〈 0. 05 ）, however, the duration of granulocytic deficiency was significantly shorter than that of the control group （ P 〈 0. 01 ）, the incidence of nausea, vomiting, diarrhea and mucositis was significantly lower than that in the control group during chemo- therapy （P 〈 0. 01 ） . [Conclusion] Enteral nutrition support can effectively improve the nutritional status of patients with leukemia chemo- therapy, and it can enhance the ability of the blood system and reduce adverse reactions, it can be used clinically.