多模态运动在食管癌合并糖尿病患者放疗期间肠内营养的应用效果

Application effect of multimodal exercise on enteral nutrition during radiotherapyin patients with esophageal cancer complicating diabetes

目的探讨多模态运动在食管癌合并糖尿病患者放疗期间肠内营养的应用效果。方法选取2021年1-12月浙江省肿瘤医院收治的52例食管癌合并糖尿病患者为研究对象,采用随机数字表法分为对照组(n=27)与干预组(n=25)。对照组采用常规运动干预,干预组在常规运动基础上给予多模态运动干预。比较两组患者放疗期间血糖代谢指标、相关生化指标及运动期间不良事件发生情况。结果干预组放疗期间空腹血糖(7.79±1.61)mmol/L、随机血糖(9.47±1.77)mmol/L、睡前血糖(9.97±3.02)mmol/L均低于对照组(11.84±3.47)mmol/L、(14.18±5.42)mmol/L、(14.62±3.83)mmol/L,差异有统计学意义(P<0.05);血清清蛋白(37.96±2.13)g/L、总蛋白(68.13±5.02)g/L、前清蛋白(232.89±41.11)g/L高于对照组(36.05±2.89)g/L、(64.96±5.95)g/L、(207.76±47.59)g/L,差异有统计学意义(P<0.05)。干预组运动期间跌倒、低血糖、意外拔管等不良事件发生率均低于对照组,差异有统计学意义(P<0.05)。结论多模态运动能明显改善食管癌合并糖尿病患者放疗期间的营养状况,稳定血糖水平,并具有较好的可行性和安全性。

Objective To explore the effect of multimodal exercise combined with enteral nutrition during radiotherapy in the patients with esophageal cancer complicating diabetes.Methods A total of 52 patients with esophageal cancer complicating diabetes in Zhejiang Provincial Tumor Hospital from January to December 2021 were selected as the study subjects and divided into the control group(n=27)and intervention group(n=25)by using the random number table method.The control group implemented the routine exercise scheme,while the intervention group was given the multimodal exercise intervention on the basis of routine exercise.The blood glucose metabolism indicators,related biochemical indicators during radiotherapy and the incidence rate of adverse events during exercise were compared between the two groups.Results The levels of fasting blood glucose,random blood glucose and blood glucose before sleep in the intervention group during radiotherapy were(7.79±1.61)mmol/L,(9.47±1.77)mmol/L and(9.97±3.02)mmol/L,which were lower than(11.84±3.47)mmol/L,(14.18±5.42)mmol/L and(14.62±3.83)mmol/L in the control group with statistically significant differences(P<0.05).During the radiotherapy period,the levels of albumin,total protein and prealbumin in the intervention group were(37.96±2.13)g/L,(68.13±5.02)g/L and(232.89±41.11)g/L,which were lower than(36.05±2.89)g/L,(64.96±5.95)g/L and(207.76±47.59)g/L in the control group with statistically significant differences(P<0.05).The incidence rates of adverse events such as falls,hypoglycemia and accidental extubation during multimodal exercise in the intervention group were lower than those in the control group,and the differences were statistically significant(P<0.05).Conclusion The multimodal exercise could significantly improve the nutritional status during radiotherapy in the patients with esophageal cancer complicating diabetes,stabilize the blood glucose level of the patients,and has good feasibility and safety.