肠内营养支持对食管癌同步放化疗患者营养状况及免疫功能作用研究

The effect of enteral nutrition support on nutritional status and immune function in treating with concurrent chemoradiotherapy esophageal cancer patients

目的研究肠内营养支持治疗对食管癌同步放化疗患者营养状况和免疫功能的影响。方法选取2014年1月至2016年1月在解放军264医院肿瘤中心接受同步放化疗的经NRS2002评估表进行筛查的具有营养不良风险的患者50例,将其随机分为肠内营养组和对照组,各25例。肠内营养组在治疗期间给予肠内营养支持,对照组常规饮食。比较两组治疗前后体能状态、营养指标、免疫功能的变化及不良反应发生情况。结果肠内营养组放疗后Karnofsky评分(KPS)、体重指数(BMI)、血红蛋白、清蛋白水平与治疗前比较,差异均无统计学意义(P>0.05);对照组KPS评分、BMI、血红蛋白、清蛋白均显著低于治疗前,差异均有统计学意义(P<0.05)。治疗后肠内营养组CD4+、CD4+/CD8+水平均显著高于对照组,差异均有统计学意义(P<0.05)。肠内营养组血液系统不良反应、放射性食管炎发生率均较对照组低,差异均有统计学意义(P<0.05),而两组胃肠道反应比较,差异无统计学意义(P>0.05)。结论食管癌同步放化疗期间积极给予肠内营养支持能有效改善患者的营养状况,增强机体免疫力,提高对放化疗的耐受性,应引起足够的重视。

Objective To investigate the effect of enteral nutrition support on nutritional status and immune function in treating with concurrent chemoradiotherapy esophageal cancer patients.Methods A total of 50 patients with esophageal cancer who underwent concurrent chemoradiotherapy and were conformed with malnutrition risk by nutritional risk screening2002(NRS2002)in our hospital from January 2014 to January 2015 were enroll in this study and randomize into enteral nutrition group and control group.The control group was given regular diet,while the enteral nutrition group was given enteral nutrition support.The indexes of Karnofsky scores(KPS),nutritional status and immune function of two groups were observed.Results The changes of KPS,body mass index(BMI),hemoglobin and serum albumin in enteral nutrition group had no statistical significance in pretreatment period(P>0.05).In control group the level of KPS,BMI,hemoglobin and serum albumin were significantly lower than that of before treatment(P<0.05),and the level of CD4+、CD4+/CD8+were also significantly lower than enteral nutrition group(P<0.05).The hematologic toxicity and the rate of radiation esophagitis in enteral nutrition group were less than those of control group(P<0.05),while the gastrointestinal reaction in the two groups had no significantly difference(P>0.05).Conclusion Enteral nutrition support can improve nutritional status,immune function and the tolerance of concurrent chemoradiotherapy in esophageal cancer patients,which is worth of wide clinical application.