思维导图康复指导结合个性化营养策略在行化学治疗胃癌患者中的应用

Application of mind mapping-based rehabilitation guidance combined with personalized nutrition strategy in gastric cancer patients undergoing chemotherapy

目的分析思维导图康复指导结合个性化营养策略在行化学治疗(简称“化疗”)胃癌患者中的应用价值。方法将2019年3月至2022年3月在徐州医科大学附属医院行化疗的94例胃癌患者纳入研究,以随机数字表法分入观察组(47例)和对照组(47例)。2组患者在化疗期间均接受常规护理及思维导图康复指导,观察组加用个性化营养策略支持。比较2组患者在化疗前后的营养状态和免疫功能变化,并比较2组化疗期间不良反应的发生情况。结果化疗1个周期后,2组的白蛋白、前白蛋白和血红蛋白水平,以及T淋巴细胞亚群CD_(3)^(+)、CD_(4)^(+)和CD_(4)^(+)/CD8+均较化疗前下降,但化疗4个周期后均较化疗1个周期后上升(P均<0.05);观察组在化疗1个周期及4个周期后的上述指标水平均优于同期对照组(P均<0.05)。观察组在化疗期间恶心和(或)呕吐、腹泻、血红蛋白下降及血小板下降的发生率与对照组相比均无统计学差异(P均>0.05),食欲下降及白细胞下降的发生率均低于对照组(P均<0.05)。结论思维导图康复指导结合个性化营养策略能够降低胃癌患者在化疗期间的不良反应发生率,且对改善患者的营养状态及免疫功能也具有积极作用。

Objective To analyze the application value of mind mapping-based rehabilitation guidance combined with personalized nutrition strategy in patients with gastric cancer undergoing chemotherapy.Methods A total of 94 patients with gastric cancer who received chemotherapy at the Affiliated Hospital of Xuzhou Medical University from March 2019 to March 2022 were included in the study.They were assigned to an observation group(47 cases)and a control group(47 cases)by the use of a random number table.Both groups received routine care and mind mapping-based rehabilitation guidance during chemotherapy,while the observation group additionally carried out personalized nutrition strategy.The changes of nutritional status and immune function of the two groups were compared before and after chemotherapy,and the incidence of adverse reactions during chemotherapy were compared between the two groups.Results After 1 cycle of chemotherapy,the levels of albumin,prealbumin,and hemoglobin,as well as the T lymphocyte subsets(CD_(3)^(+),CD_(4)^(+),and CD_(4)^(+)/CD8+),in both groups decreased when compared with those before chemotherapy,but these indicators increased after 4 cycles of chemotherapy when compared with those after 1 cycle of chemotherapy(all P<0.05).The levels of the above indicators in the observation group were better than those in the control group after 1 and 4 cycles of chemotherapy(all P<0.05).During chemotherapy,the incidences of nausea or vomiting,diarrhea,decreased hemoglobin,and decreased platelet count in the observation group were not significantly different from those in the control group(all P>0.05).The incidences of decreased appetite and decreased white blood cell count in the observation group were lower than those in the control group(both P<0.05).Conclusion The combination of mind mapping-based rehabilitation guidance and personalized nutrition strategy can reduce the incidence of adverse reactions during chemotherapy in gastric cancer patients,and has a positive effect on improving the nutritional status and immune function of patients.