肠内营养在Ⅲ期结肠癌术后辅助化疗中的应用价值

A Clinical Study on the Enteral Nutrition for the Adjuvant Chemotherapy of Stage Ⅲ Colon Cancer

目的:探讨肠内营养在Ⅲ期结肠癌术后辅助化疗中的应用价值。方法:对Ⅲ期结肠癌术后辅助化疗的患者常规进行NRS-2002评分,筛选具有营养风险的68例患者,将其随机分为肠内营养联合XELOX方案化疗组及单纯XELOX方案化疗组,对比其消化道副作用、骨髓抑制、神经毒性、手足综合征等化疗副作用的发生情况;体重、血红蛋白、血清白蛋白等营养指标的变化;治疗期间肿瘤复发及转移情况,并评价治疗疗效。结果:肠内营养联合化疗组在化疗期间无肿瘤复发及转移,肠内营养+XELOX组患者恶心呕吐及腹泻的发生率较XELOX组明显降低(P<0.05);两组骨髓抑制、神经毒性、手足综合征等副作用均较轻,差异无统计学意义(P>0.05)。肠内营养联合化疗组在化疗后血清白蛋白、体重等指数均较化疗前升高,单纯化疗组反而降低;两组间血红蛋白变化无统计学差异(P>0.05)。结论:肠内营养在Ⅲ期结肠癌术后有营养风险的辅助化疗患者中具有优越性,可改善患者的营养状态,减轻化疗反应,增强化疗疗效。

Objective: To investigate the application value of enteral nutrition in adjuvant chemotherapy after operation for stage Ⅲ colon cancer. Methods: 68 patients with nutritional risk were screened by NRS-2002 score. They were randomly divided into enteral nutrition combined with XELOX regimen chemotherapy group and simple XELOX regimen chemotherapy group. The side effects of digestive tract, bone marrow suppression, neurotoxicity, hand-foot syndrome, weight, hemoglobin and serum albumin were compared. Nutrition index changes;Tumor recurrence and metastasis during treatment, evaluation of therapeutic efficacy. Results: There was no recurrence or metastasis of tumors in the enteral nutrition combined with chemotherapy group. The incidence of nausea, vomiting and diarrhea in the enteral nutrition + XELOX group was significantly lower than that in the XELOX group(P<0.05), bone marrow suppression, neurotoxicity, hand-foot syndrome and other side effects of the two groups are mild, the statistical difference is not significant. After chemotherapy, serum albumin and body mass index in enteral nutrition combined with chemotherapy group were higher than those before chemotherapy, while those in chemotherapy group were lower. There was no significant difference in hemoglobin between the two groups. Conclusion: Enteral nutrition is superior to adjuvant chemotherapy for patients with nutritional risk after operation of stage Ⅲ colon cancer. It can improve the nutritional status of patients, alleviate the reaction of chemotherapy and enhance the curative effect of chemotherapy.