免疫增强型肠内营养支持联合化疗对老年晚期结直肠癌患者营养状态和免疫功能的影响

Effect of immune-enhancing enteral nutrition support combined with chemotherapy on nutritional status and immune function of elderly patients with advanced colorectal cancer

目的探析免疫增强型肠内营养支持联合化疗对老年晚期结直肠癌患者营养状态及免疫功能的影响。方法选取2017年5月至2020年5月于淮安市第一人民医院接受治疗的60例老年晚期结直肠癌患者作为研究对象,按照随机数字表法将其分为观察组和对照组,每组各30例。对照组患者接受化疗,观察组在对照组的基础上联合免疫增强型肠内营养支持。比较两组患者治疗前后的营养状态指标[体重指数(BMI)、清蛋白(Alb)含量、转铁蛋白(TF)含量]、免疫功能指标[T淋巴细胞(CD3^(+)、CD4^(+)、CD8^(+))]水平及并发症发生情况,并采用肿瘤患者生存质量评分[功能状态评分(KPS)、体力状况评分(ZPS)、生活质量评分(QOL)]评估其预后情况。结果观察组患者治疗后的BMI、Alb、TF、CD3^(+)、CD4^(+)、CD8^(+)、KPS、QOL评分均高于对照组,ZPS评分低于对照组,差异有统计学意义(P<0.05)。观察组患者的并发症总发生率为10.00%(3/30),低于对照组的26.67%(8/30),差异有统计学意义(P<0.05)。结论免疫增强型肠内营养支持联合化疗可有效改善患者的营养状态及免疫功能,可促进患者顺利实施治疗,且患者经二者联合治疗后其并发症发生风险更低,生存质量也得到显著提升,此疗法具有较高的临床价值,建议进一步推广应用。

Objective To explore the effect of immune-enhancing enteral nutrition support combined with chemotherapy on the nutritional status and immune function of elderly patients with advanced colorectal cancer.Methods Sixty elderly patients with advanced colorectal cancer who were treated at Huai′an First Hospital Affiliated to Nanjing Medical University from May 2017 to May 2020 were selected as the research objects.All patients were divided into observation group and control group according to the random number table method,with 30 cases in each group.The control group received chemotherapy,the observation group was combined with immune-enhanced enteral nutrition support on the basis of the control group.Nutritional status indicators(body mass index[BMI],albumin[Alb]content,transferrin[TF]content),immune function indicators(T lymphocyte[CD3^(+),CD4^(+),CD8^(+)])levels and complications were compared between the two groups before and after treatment.Quality of life score(Karnofsky[KPS],Zubrod performance status[ZPS],quality of life score[QOL])was used to evaluate the prognosis.Results After treatment,BMI,Alb,TF,CD3^(+),CD4^(+),CD8^(+),KPS and QOL scores of observation group were higher than those of control group,and the ZPS scores were lower than those of the control group,the differences were statistically significant(P<0.05).The total incidence of complications in the observation group was 10.00%(3/30),lower than 26.67%(8/30)in the control group,and the difference was statistically significant(P<0.05).Conclusion Immune-enhancing enteral nutrition support combined with chemotherapy can effectively improve the nutritional status and immune function of patients,and can promote the smooth implementation of treatments.After the combined treatment of the two,the risk of complications is lower and the quality of life has also been significantly improved.This therapy has high clinical value and it is recommended to be further promoted and applied.