术前新辅助化疗联合肠内肠外营养支持治疗胃癌幽门梗阻的临床疗效及安全性

Clinical efficacy and safety of preoperative neoadjuvant chemotherapy combined with parenteral and enteral nutrition support in the treatment of pyloric obstruction of gastric cancer

目的 探讨术前新辅助化疗联合肠内肠外营养支持治疗胃癌幽门梗阻的临床效果及安全性。方法 回顾性分析90例胃癌幽门梗阻患者的临床资料,将单纯接受术前新辅助化疗治疗的45例患者设为参考组,接受术前新辅助化疗联合肠内肠外营养的45例患者设为观察组,观察2组患者营养状况、近期及远期预后等。结果 干预前,2组患者主观整体营养评估(PG-SGA)评分、生活质量评估量表(QOL)评分差异无统计学意义(P>0.05);干预后,观察组PG-SGA评分显著低于参考组,QOL评分显著高于参考组(P<0.05);观察组的肿瘤切除率、根治性切除率均显著高于参考组,术后并发症发生率显著低于参考组(P<0.05);观察组术后3年内复发率、转移率、病死率均显著低于参考组(P<0.05)。结论 术前新辅助化疗联合肠内、肠外营养支持治疗胃癌幽门梗阻能够改善机体营养状况及患者生活质量,对手术近期、远期效果的提高有积极意义,同时可降低并发症发生风险。

Objective To investigate the clinical effect and safety of preoperative neoadjuvant chemotherapy combined with parenteral and enteral nutrition support in the treatment of pyloric obstruction of gastric cancer. Methods The clinical data of 90 patients with pyloric obstruction of gastric cancer treated in our hospital in recent years were retrospectively analyzed,among whom 45 patients received preoperative neoadjuvant chemotherapy alone were selected as the reference group and 45 patients received preoperative neoadjuvant chemotherapy combined with parenteral as well as enteral nutrition were selected as the observation group. The nutritional status,short-term and longterm prognosis of the two groups were observed. Results Before intervention,there were no significant differences between the two groups in the subjective total nutrition assessment( PG-SGA) score and the quality of life assessment scale( QOL) score( P > 0. 05). After intervention,the PG-SGA scores of the observation group was significantly lower,and the QOL score was significantly higher than that of the reference group( P < 0. 05). The resection rate of tumor and radical resection rate were significantly higher,and the incidence of postoperative complications was significantly lower than that of the reference group( P < 0. 05). The recurrence rate,metastasis rate and mortality rate within3 years after operation of the observation group were significantly lower than those of the reference group( P < 0. 05). Conclusion Preoperative neoadjuvant chemotherapy combined with parenteral as well as enteral nutrition support in the treatment of pyloric obstruction of gastric cancer can improve the nutritional status of the body and the quality of life of patients. Meanwhile,it can improve theshort-term and long-term effect of surgery,and reduce the risk of complications.