营养教育联合口服营养补充对结直肠癌化疗患者临床结局的影响

Effect of nutrition education combined with oral nutrition supplementation on clinical outcomes of patients with colorectal cancer chemotherapy

目的评估营养教育联合口服补充肿瘤全营养制剂对结直肠癌化疗患者营养状况和临床结局的影响。方法选取90例能口服食物且营养风险筛查2002(NRS2002)≥3分的结直肠癌化疗患者,按照随机数字表分为研究组(n=45,营养教育联合口服补充肿瘤全营养制剂)和对照组(n=45,营养教育),比较化疗前后两组患者的能量补充、营养情况、化疗不良反应发生率等。结果化疗前后比较,研究组每天口服营养能量总量显著增加[(7726±709)kJ比(7447±715)kJ,P<0.05];研究组患者白蛋白和前白蛋白水平显著升高[(37.80±2.87)g/L比(39.67±2.03)g/L,P<0.05;(252.98±50.35)mg/L比(283.47±32.96)mg/L,P<0.05]。另外,与对照组比较,研究组患者三级骨髓抑制和三级消化道反应发生率显著下降(17.8%比40.0%,P=0.02;15.6%比42.2%,P=0.005)。结论营养教育联合口服营养补充可改善结直肠癌化疗患者的营养状况,降低化疗相关副反应的发生率,改善了临床结局。

Objective To evaluate the effect of nutrition education combined with oral tumor supplements on nutritional status and clinical outcomes of patients with colorectal cancer chemotherapy.Methods 90 patients with colorectal cancer chemotherapy who can take food orally and have a nutritional risk screening 2002(NRS2002)≥3 points were selected.They were divided into study groups(n=45,nutrition education combined with oral nutritional supplements for total tumor preparations)and control group(n=45,nutrition education)by random number table,energy supplement,nutritional status,incidence of adverse reactions to chemotherapy,etc.were compared.before and after chemotherapy.Results Compared with before and after chemotherapy,the total daily oral nutritional energy in the study group increased significantly[(7726±709)kJ vs(7447±715)kJ,P<0.05];the albumin and prealbumin levels of patients in the research group significantly increased[(37.80±2.87)g/L vs(39.67±2.03)g/L,P<0.05;(252.98±50.35)mg/L vs(283.47±32.96)mg/L,P<0.05].Compared with the control group,the incidence of tertiary bone marrow transplantation and tertiary gastrointestinal reactions in the study group were significantly reduced(17.8%vs 40.0%,P=0.02;15.6%vs 42.2%,P=0.005).Conclusion Nutrition education combined with oral nutritional supplementation can improve the nutritional status of patients with colorectal cancer chemotherapy,reduce the incidence of chemotherapy-related adverse reactions,and improve clinical outcomes.