经鼻空肠管肠内营养支持对晚期胃癌患者营养状况和免疫功能及近期生活质量的影响

Effect of nasoenteric nutrition on nutritional status,immune function and short-term quality of life in patients with advanced gastric cancer

目的分析经鼻空肠管肠内营养支持对晚期胃癌患者营养状况、免疫功能以及近期生活质量的影响。方法选取东南大学附属中大医院2015年1月至2018年12月收治的106例晚期胃癌患者作为研究对象,根据患者是否进行鼻空肠管营养支持分为肠内营养组(48例)和对照组(58例)。所有患者均接受奥沙利铂+替吉奥化疗3个周期,对照组患者化疗期间给予营养指导,制定饮食计划,肠内营养组患者给予鼻空肠管营养支持。比较2组患者化疗前后营养指标、免疫功能、生活质量及不良反应发生率。结果化疗后,肠内营养组患者血清前白蛋白、白蛋白水平均明显高于对照组[(183±21) g/L比(169±22)g/L、(34±7)g/L比(31±6) g/L],差异均有统计学意义(均P <0. 05)。化疗后,肠内营养组CD3^+、CD4^+水平及CD4^+/CD8^+比值均明显高于对照组,CD8^+水平明显低于对照组,差异均有统计学意义(均P <0. 05)。化疗后,肠内营养组欧洲癌症研究与治疗组织生活质量核心30问卷调查功能量表各条目评分及整体健康状况评分均明显高于对照组,症状量表各条目评分及单项测量条目评分均明显低于对照组,差异均有统计学意义(均P <0. 05)。2组患者不良反应发生率比较,差异均无统计学意义(均P> 0. 05)。结论经鼻空肠管肠内营养支持可以改善晚期胃癌患者营养状况、免疫功能以及生活质量。

Objective To analyze the effect of nasoenteric nutrition on nutritional status,immune function and short-term quality of life in patients with advanced gastric cancer. Methods A total of 106 patients with advanced gastric cancer admitted to Zhongda Hospital Southeast University from January 2015 to December 2018 were included. All patients were treated with oxaliplatin + tegafur chemotherapy for 3 circles. During chemotherapy,48 patients had enteral nutrition support through nasoenteric feeding tube( enteral nutrition group);58 patients had conventional nutrition guidance and diet intervention( control group). Nutritional indicators,immune function,quality of life and adverse reactions were analyzed. Results After chemotherapy,levels of serum prealbumin and albumin in enteral nutrition group were significantly higher than those in control group[(183 ± 21) g/L vs(169 ±22) g/L,(34 ± 7) g/L vs(31 ± 6) g/L]( both P < 0. 05). Levels of CD3^+,CD4^+ and CD4^+/CD8^+ in enteral nutrition group were significantly higher and CD8+was significantly lower than those in control group( all P < 0. 05). Scores of separate items in Quality of Life Questionnaire 30 functional scale and the overall health score in enteral nutrition group were significantly higher than those in control group;scores of separate items in symptom scale in enteral nutrition group were significantly lower than those in control group( all P < 0. 05). There was no significant difference in the incidence of adverse reactions between groups( P > 0. 05). Conclusion Nasoenteric nutrition support can improve nutritional status,immune function and quality of life in patients with advanced gastric cancer.