多学科诊疗模式营养管理在老年食管癌化疗患者中的应用效果

Application effect of multidisciplinary team nutritional management in elderly esophageal cancer patients undergoing chemotherapy

目的 探讨多学科诊疗模式(MDT)营养管理在老年食管癌化疗患者中的应用效果。方法 根据干预方式的不同将102例老年食管癌化疗患者分为对照组(n=51)和观察组(n=51),对照组患者采取常规干预,观察组患者在对照组的基础上采取MDT营养管理。比较两组患者的营养状况[总蛋白(TP)、白蛋白(ALB)、前白蛋白(PA)、患者自评-主观全面评定量表(PG-SGA)评分]、血常规指标[白细胞(WBC)、血小板(PLT)、血红蛋白(Hb)]、生活质量[欧洲癌症研究与治疗组织生命质量测定量表(EORTC QLQ-C30)]及不良反应发生情况。结果干预后,观察组患者TP、ALB、PA水平均高于对照组,PG-SGA评分低于对照组,差异均有统计学意义(P﹤0.05)。干预后,两组患者WBC、PLT水平均低于本组干预前,观察组患者WBC、PLT水平均高于对照组,差异均有统计学意义(P﹤0.05)。干预后,两组患者躯体功能、情绪功能、社会功能、认知功能、总体生活质量评分均高于本组干预前,观察组患者上述评分均高于对照组,差异均有统计学意义(P﹤0.05)。观察组患者发热、骨髓抑制、恶心呕吐发生率均低于对照组,差异均有统计学意义(P﹤0.05)。结论 MDT营养管理能够改善老年食管癌化疗患者的营养状况,提高患者的生活质量,降低不良反应发生率。

Objective To investigate the application effect of multidisciplinary team(MDT)nutritional management in elderly esophageal cancer patients undergoing chemotherapy.Method A total of 102 elderly patients with esophageal cancer treated by chemotherapy were divided into control group(n=51,received routine intervention)and observation group(n=51,received MDT nutritional management on the basis of the control group)according to different intervention methods.The nutritional status[total protein(TP),albumin(ALB),prealbumin(PA),and patient-generated subjective global assessment(PG-SGA)score],blood routine indexes[white blood cell(WBC),platelet(PLT)and hemoglobin(Hb)],quality of life[European Organization for Research and Treatment of Cancer quality of life questionnaire core 30(EORTC QLQ-C30)]and incidence of adverse reactions were compared between the two groups.Result After interven-tion,the levels of TP,ALB and PA in the observation group were higher than those in the control group,and the PG-SGA score was lower than that in the control group,and the differences were statistically significant(P<0.05).After interven-tion,the levels of WBC and PLT in the two groups were lower than those before intervention,the levels of WBC and PLT in the observation group were higher than those in the control group,and the differences were statistically significant(P<0.05).After intervention,the scores of physical function,emotional function,social function,cognitive function and total scores of quality of life in both groups were higher than those before intervention,with higher scores in the observation group than those in the control group,and the differences were statistically significant(P<0.05).The incidence of fever,bone marrow suppression,nausea and vomiting in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).Conclusion MDT nutritional management can improve the nutri-tional status of elderly esophageal cancer patients undergoing chemotherapy,improve the quality of life,and reduce the in-cidence of adverse reactions.