老年晚期肿瘤病人免疫营养支持治疗分析

Significance of nutritional support in elderly patients with advanced cancer

目的探讨免疫增强型肠内营养联合肠外营养支持治疗老年晚期癌症病人的疗效。方法选取2015~2018年本院肿瘤内科收治的84例老年晚期恶性肿瘤病人(42例晚期消化系统肿瘤病人,42例晚期非消化系统肿瘤病人),采用营养风险筛查量表(NRS 2002)和病人自评主观全面评定量表(PG-SGA)进行营养筛查和评价,并给予4周免疫增强型肠内营养液瑞能联合肠外营养支持治疗。检测入组病人治疗前后BMI、Hb、白蛋白(ALB)、前白蛋白(PA)、三头肌皮褶厚度(TSF)、上臂肌围(AMC)等指标,以及免疫指标淋巴细胞绝对值、血清IgG、IgM,T淋巴细胞亚群CD3^+、CD4^+、CD4^+/CD8^+水平。结果与治疗前相比,营养支持4周后病人营养指标以及免疫指标绝对值水平均有升高,差异均有统计学意义(P<0.05)。结论营养支持治疗能在一定程度上改善晚期肿瘤病人营养不良的情况,提高晚期肿瘤病人免疫功能。

Objective To investigate the clinical effect of application of enteral and parenteral nutrition support in the elderly patients with advanced cancer.Methods A total of 84 patients with advanced cancer(42 with digestive system malignancies and 42 without digestive system malignancies)were screened and assessed by NRS 2002 and PG-SGA in this study.Before and after 4 weeks’nutrition support,the nutritional indicators such as body mass index(BMI),albumin(ALB),hemoglobin(Hb),prealbumin(PA),triceps skin fold thickness(TSF),arm muscle circumference(AMC)and immune indicators such as lymphocyte count,IgG,IgM,CD3^+,CD4^+,CD4^+/CD8^+were also detected.Results Nutritional indicators such as BMI,ALB,Hb,PA and immune indicators were increased significantly after enteral and parenteral nutrition support.Conclusions The application of enteral and parenteral nutrition support can improve the nutrition and immune function in the elderly patients with advanced cancer.