全程营养支持对新辅助同步放化疗直肠癌患者治疗效果、耐受性及其营养状态的影响

Influence of Full Nutritional Support on Therapeutic Effect,Tolerance and Nutritional Status of Patients with Rectal Cancer Undergoing Neoadjuvant Concurrent Chemoradiotherapy

目的:探讨全程营养支持对新辅助同步放化疗直肠癌患者治疗效果、耐受性及其营养状态的影响。方法:选取2021年2月至2023年2月我院收治的84例接受新辅助同步放化疗的直肠癌患者实施前瞻性研究,按照随机数字表法分为研究组和对照组,各42例。对照组实施常规护理及营养干预,研究组实施全程营养支持,在对照组基础上,治疗全过程每日口服肠内营养剂(安素)。比较2组新辅助放化疗治疗效果、耐受性、营养状况及不良反应发生状况。结果:2组患者新辅助放化疗后均顺利完成手术治疗。研究组新辅助放化疗后T分期、N分期降期率(59.52%,54.76%)均高于对照组(35.71%,30.95%),P<0.05。研究组和对照组R0切除率(97.62%,95.24%)无明显差异,P>0.05。研究组保肛率(64.29%)高于对照组(40.48%),P<0.05。与对照组相比,研究组放化疗中断率更低,P<0.05。与干预前相比,干预后研究组前白蛋白(PA)、白蛋白(ALB)、血红蛋白(Hb)变化不明显(P>0.05),仅身体质量指数(BMI)明显降低(P<0.05);干预后对照组PA、ALB、Hb及BMI均明显降低(P<0.05)。干预后2组间比较,研究组PA、ALB、Hb和BMI均明显低于对照组(P<0.05)。2组≥3级的急性胃肠道反应、手足综合征发生率比较差异无统计学意义,P>0.05;研究组≥3级的骨髓抑制、急性放射性直肠炎发生率低于对照组,P<0.05。结论:对新辅助同步放化疗直肠癌患者全程进行营养支持,可有效提高治疗效果与耐受性,改善患者营养状态,减少不良反应。

Objective To explore the influence of full nutritional support on the therapeutic effect,tolerance and nutritional status of patients with rectal cancer undergoing neoadjuvant concurrent chemoradiotherapy.MI ethods A prospective study was conducted on 84 rectal cancer patients undergoing neoadjuvant concurrent chemoradiotherapy admitted to our hospital from February 2021 to February 2023.They were divided into the study group and the control group according to the random number table method,with 42 cases in each group.The control group was given routine nursing and nutritional intervention,while the study group was given full nutritional support.On the basis of the control group,the study group was given oral enteral nutrition(Ensure)daily throughout the treatment.The therapeutic effect,tolerance,nutritional status and adverse reactions of the two groups were compared.ResultsThe two groups of patients successfully completed surgical treatment after neoadjuvant chemoradiotherapy.The T stage and N stage decline rates after neoadjuvant chemoradiotherapy in the study group(59.52%,54.76%)were higher than those in the control group(35.71%,30.95%)(P<0.05).There was no significant difference in the Ro resection rate between the study group and the control group(97.62%,95.24%)(P>0.05).The anal sphincter preservation rate in the study group(64.29%)was higher than that in the control group(40.48%)(P<0.05).Compared with the control group,the interruption rate of chemoradiotherapy in the study group was lower(P<0.05).Compared with before intervention,the changes of prealbumin(PA),albumin(ALB),hemoglobin(Hb)in the study group after intervention were not significant(P>0.05),only body mass index(BMI)was significantly decreased(P<0.05).After intervention,PA,ALB,Hb and BMI in the control group were significantly decreased(P<0.05).After intervention,the comparison between the two groups showed that PA,ALB,Hb and BMI in the study group were significantly lower than those in the control group(P<o.05).There was no significant difference in the incidence of acute gastrointestinal reaction no less than level 3 and hand-foot syndrome between the two groups(P>0.05).The incidence of bone marrow suppression and acute radiation proctitis no less than level 3 in the study group were lower than those in the control group(P<0.05).Conclusion Full nutritional support for rectal cancer patients with neoadjuvant concurrent chemoradiotherapy can effectively improve the therapeutic effect and tolerance,improve the nutritional status of patients and reduce adverse reactions.