不同营养支持方案对食管癌患者同步放化疗期间不良反应的影响

Effects of Different Nutritional Support Programs on Adverse Reactions during Concurrent Chemoradiotherapy in Patients with Esophageal Cancer

【目的】探讨不同营养支持方案对食管癌患者同步放化疗期间不良反应的影响。【方法】本院收治的96例食管癌患者,随机分为观察组与对照组,每组48例。对照组患者除常规饮食外,给予口服营养素,观察组患者给予肠内营养支持。比较两组患者的疗效、治疗期间不良反应发生情况及治疗前后体重指数(BMI)、主观整体评估量表(PG-SGA)评分、血清白蛋白(ALB)、血红蛋白(Hb)、血清转铁蛋白(TF)及T淋巴细胞(CD4+、CD8+、CD4+/CD8+)水平。【结果】两组治疗有效率比较,差异无统计学意义(P>0.05)。治疗后,观察组BMI、PG-SGA评分高于治疗前,对照组BMI低于治疗前,PG-SGA评分高于治疗前(P<0.05);观察组治疗后BMI高于对照组,PG-SGA评分低于对照组(P<0.05)。治疗后,观察组ALB、Hb、TF水平高于治疗前,对照组低于治疗前(P<0.05);观察组治疗后血清ALB、Hb、TF水平高于对照组(P<0.05)。治疗后,观察组CD4+、CD8+、CD4+/CD8+与治疗前比较,差异无统计学意义(P>0.05),对照组CD4+、CD4+/CD8+低于治疗前及观察组(P<0.05),CD8+比较,差异无统计学意义(P>0.05)。观察组治疗期间感染、骨髓抑制≥3级的发生率显著低于对照组(P<0.05),两组放射性肺炎≥3级、放射性食管炎≥3级的发生率相比较,差异无统计学意义(P>0.05)。【结论】肠内营养支持方案用于食管癌患者同步放化疗期间可改善患者营养状况,增强免疫功能,减少感染、骨髓抑制的发生率,提高放化疗耐受性。

【Objective】To investigate the effects of different nutritional support programs on adverse reactions during concurrent chemoradiotherapy in patients with esophageal cancer.【Methods】A total of 96 patients with esophageal cancer treated in our hospital were randomly divided into the observation group and the control group,with 48 cases in each group.The patients in the control group were given oral nutrients in addition to regular diet,and the patients in the observation group were given enteral nutrition support in addition to routine diet.The treatment effect,adverse reactions during treatment,body mass index(BMI),subjective global assessment scale(PG-SGA)score,serum albumin(ALB),hemoglobin(Hb),serum transferrin(TF)and T lymphocyte(CD4+,CD8+,CD4+/CD8+)levels before and after treatment were compared between the two groups.【Results】There was no significant difference in the effective rate of treatment between the two groups(P>0.05).After treatment,the BMI and PG-SGA score in the observation group were higher than those before treatment.The BMI in the control group was lower than that before treatment,and the PG-SGA score in the control group was higher than that before treatment(P<0.05).After treatment,the BMI of the observation group was higher than that of the control group,and the PG-SGA score was lower than that of the control group(P<0.05).The levels of ALB,Hb and TF in the observation group after treatment were higher than those before treatment,and those in the control group were lower than those before treatment(P<0.05).After treatment,there were no significant differences in CD4+,CD8+,CD4+/CD8+in the observation group compared with those before treatment(P>0.05).Both CD4+and CD4+/CD8+in the control group were lower than those before treatment and the observation group(P<0.05),and there was no significant difference in CD8+among those comparisons(P>0.05).The incidences of infection and myelosuppression≥grade 3 in the observation group were significantly lower than those in the control group(P<0.05).There was no significant difference in the incidence of radiation pneumonitis≥grade 3 and radiation esophagitis≥grade 3 between the two groups(P<0.05).【Conclusion】Enteral nutrition support program for patients with esophageal cancer during concurrent radiotherapy and chemotherapy can improve nutritional status,enhance immune function,reduce the incidence of infection and myelosuppression,and improve radiotherapy and chemotherapy tolerance.