全程精细化营养管理对进展期直肠癌短程放疗联合化疗患者营养状况、免疫功能及生活质量的影响

Effects of whole-course refined nutrition management on nutritional status,immune function and life quality of patients with advanced rectal cancer treated by brachytherapy combined with chemotherapy

目的探讨全程精细化营养管理对进展期直肠癌短程放疗联合化疗患者营养状况、免疫功能及生活质量的影响。方法选取该院收治的80例进展期直肠癌短程放疗联合化疗患者为研究对象,分为观察组和对照组,每组40例。观察组应用全程精细化营养管理模式,对照组给予常规营养管理模式。比较两组患者干预前后血清血红蛋白(Hb)、血清清蛋白(Alb)、前清蛋白(PAB)、转铁清蛋白(TRF)、体质量指数(BMI)、自评主观全面评定量评分(PG-SGA评分)等营养及评估指标,检测IgA、IgG、IgM、CD3+、CD4+等免疫指标,记录两组患者生活质量评分。结果入院时,两组患者各项指标差异无统计学意义(P>0.05)。治疗后,观察组患者血清Hb、PAB、Alb均明显高于对照组(P<0.05),而PG-SGA评分则明显低于对照组(P<0.05);观察组患者血清IgA、IgG、IgM、CD3+、CD4+,以及食欲情况、精神状况、睡眠质量、家庭理解配合、日常生活情况等生活质量评分均明显高于对照组(P<0.05)。结论全程精细化营养管理可明显改善进展期直肠癌短程放疗联合化疗患者营养和免疫状况,提高生活质量,有利于治疗的延续。

Objective To investigate the effects of whole-course refined nutrition management on nutritional status,immune function and life quality of patients with advanced rectal cancer treated by brachytherapy combined with chemotherapy.Methods A total of 80 patients with advanced rectal cancer treated by brachytherapy combined with chemotherapy in this hospital were prospectively selected and randomly individed into two groups(40 cases in each group).The patients in the observation group accepted the whole-course refined nutrition management model,and the patients in the control group was given the conventional nutrition management model.Nutrition and evaluation indexes such as serum hemoglobin(Hb),prealbumin(PAB),serum albumin,transferrin albumin(TRF),body mass index(BMI),self-reported subjective comprehensive evaluation of quantitative score(PG-SGA)before and after the intervention were compared.The levels of serum IgA,IgG,IgM,CD3+,CD4+were detected.Life quality score were recorded between the two groups.Results There was no significant difference between the two groups in all indexes and scores before treatment(P>0.05).The level of serum Hb,PAB and Alb in the observation group were significantly higher than those in the control group(P<0.05),while PG-SGA score was significantly lower than that in the control group after treatment(P<0.05).The levels of serum IgA,IgG,IgM,CD3+,CD4+in the observation group were significantly higher than those in the control group,scores of appetite,mental status,sleep quality,family understanding and coordination,daily life in the observation group were significantly higher than those in the control group(P<0.05).Conclusion For the patients with advanced rectal cancer treated by brachytherapy combined with chemotherapy,the whole process of refined nutrition management can significantly improve their nutritional status,improve the immunity,and enhance the life quality,which is conducive to the continuation of treatment.