分析个体化营养护理与行为干预对食管癌放疗患者营养状况、免疫功能和癌性疲乏的影响

Effects of Individualized Nutritional Care and Behavioral Intervention on Nutritional Status, Immune Function and Cancer Fatigue in Patients with Esophageal Cancer Undergoing Radiotherapy

目的:探讨个体化营养护理与行为干预对食管癌放疗患者营养状况、免疫功能和癌性疲乏的影响。方法:选择2018年9月—2020年9月河南科技大学第一附属医院收治的168例食管癌放疗患者作为研究对象,按随机数表法分为对照组与观察组,每组各 84 例。对照组采用常规护理,观察组实施个体化营养护理与行为干预。对比分析两组患者营养状况、免疫功能及癌性疲乏。结果:干预前,两组患者血清白蛋白 (ALB)、转铁蛋白 (TFN) 比较,差异无统计学意义 (t=0.181、0.538,P>0.05);干预后,观察组ALB (35.41±3.24) g/L、TFN (2.37±0.34) g/L水平高于对照组,差异有统计学意义 (t=13.693、10.133,P<0.05);干预前,两组患者 CD4^(+)、CD8^(+)、自然杀伤细胞 (NK) 水平比较,差异无统计学意义(t=0.997、0.176、0.532,P>0.05);干预后,观察组 CD4^(+)(42.56±3.23) %、NK (13.37±1.13) %水平高于对照组,CD8^(+)(23.19±1.17) %水平低于对照组,差异有统计学意义 (t=8.408、6.480、7.353,P<0.05);干预前,两组患者简易疲乏量表(BFI) 评分比较,差异无统计学意义 (t=0.511,P>0.05);干预后,观察组 BFI 评分 (2.21±0.73) 分,显著低于对照组(4.38±1.10) 分,差异有统计学意义 (t=15.065,P<0.05)。结论:个体化营养护理与行为干预能够明显改善食管癌放疗患者的营养状况,促进其免疫功能恢复,缓解癌性疲乏,利于减轻患者痛苦。

Objective:To explore the effect of individualized nutritional nursing and behavioral intervention in patients with esophageal cancer undergoing radiotherapy.Methods:A total of 168 patients with esophageal cancer radiotherapy admitted to the hospital from September 2018 to September 2020 were selected and divided into the control group and the observation group ac⁃cording to the random number table method,with 84 cases in each group.The control group received routine nursing,while the ob⁃servation group received individualized nutritional nursing and behavioral intervention.The nutritional status,immune function and cancer-related fatigue of the two groups were compared and analyzed.Results:Before intervention,there was no statistically signifi⁃cant difference in the level of serum albumin(ALB)and transferrin(TFN)between the two groups(t=0.181,0.538,P>0.05).After intervention,the level of ALB(35.41±3.24)g/L and TFN(2.37±0.34)g/L in the observation group were higher than those in the control group,and the difference was statistically significant(t=13.693,10.133,P<0.05).Before intervention,there was no statisti⁃cally significant difference in the level of CD4^(+),CD8^(+),and natural killer(NK)cells between the two groups(t=0.997,0.176,0.532,P>0.05).After the intervention,the level of CD4^(+)(42.56±3.23)%and NK(13.37±1.13)%in the observation group were higher than those in the control group,and CD8^(+)(23.19±1.17)%in the observation group were lower than those in the control group,and the difference was statistically significant(t=8.408,6.480,7.353,P<0.05).Before the intervention,there was no statistically signifi⁃cant difference in the simplified fatigue scale(BFI)between the two groups(t=0.511,P>0.05).After the intervention,the BFI score of the observation group was(2.21±0.73)points,which was significantly lower than(4.38±1.10)points of the control group,and the difference was statistically significant(t=15.065,P<0.05).Conclusion:Individualized nutritional care and behavioral in⁃tervention can significantly improve the nutritional status of patients with esophageal cancer radiotherapy,promote the recovery of their immune function,relieve cancer fatigue,and help alleviate the pain of patients.