肠内营养支持对转移性结直肠癌患者生存质量及疗效的影响分析

Effect of enteral nutrition support on quality of life and therapeutic effect in patients with metastatic colorectal cancer

目的探究肠内营养支持对转移性结直肠癌患者生存质量及治疗疗效的影响。方法选取南京鼓楼医院集团安庆市石化医院2020年1月至2023年12月收治的转移性结直肠癌患者合计100例,使用随机数字表法将患者分为肠外营养组、肠内+肠外营养组各50例。肠外营养组行肠外营养,肠内+肠外营养组在其基础上加用肠内营养。比较两组治疗疗效及治疗前后营养学指标、肠道菌群、生存期、生存质量。结果肠内+肠外营养组治疗有效率为76.00%,肠外营养组为54.00%,肠内+肠外营养组高于肠外营养组(P<0.05);干预前两组营养指标、菌群失调分级、QLQ-C30评分差异无统计学意义(P>0.05),干预后肠内+肠外营养组白蛋白为(38.76±6.02)g/L、总蛋白为(64.09±6.71)g/L、菌群正常和I度失调例数为46例、生存期为(17.055±4.33)个月、躯体功能评分为(74.59±7.55)分、情绪功能评分为(78.94±7.96)分、认知功能评分为(88.95±9.03)分、角色功能评分为(85.49±8.61)分、社会功能评分为(81.45±8.27)分,肠外营养组白蛋白为(34.51±5.47)g/L、总蛋白为(58.91±6.55)g/L、菌群正常和I度失调例数为33例、生存期为(12.48±3.59)个月、躯体功能评分为(67.21±6.81)分、情绪功能评分为(73.55±7.78)分、认知功能评分为(83.47±8.55)分、角色功能评分为(80.14±8.26)分、社会功能评分为(76.93±7.827)分,肠内+肠外营养组高于肠外营养组(P<0.05)。肠内+肠外营养组转铁蛋白为(1.45±0.57)g/L、II度菌群失调例数为2例、III度菌群失调例数为2例,肠外营养组转铁蛋白为(1.71±0.61)g/L、II度菌群失调例数为8例、III度菌群失调例数为9例,肠内+肠外营养组低于肠外营养组(P<0.05)。结论肠内+肠外营养支持有助于提高转移性结直肠癌治疗效果,提高患者营养状态及生存期,改善患者生存质量。

ObjectiveTo investigate the effect of enteral nutrition support on quality of life and therapeutic effect in patients with metastatic colorectal cancer.MethodsA total of 100 patients with metastatic colorectal cancer admitted to Anqing Petrochemical Hospital from Jan.2020 to Dec.2023 were selected and divided into parenteral nutrition group and enteral+parenteral nutrition group with 50 cases each using random number table method.The parenteral nutrition group received parenteral nutrition,and the parenteral+parenteral nutrition group was supplemented with enteral nutrition.The therapeutic effect,nutritional indexes,intestinal flora,survival time and quality of life before and after treatment were compared between the two groups.ResultsThe effective rate of enteral+off-site nutrition group was 76.00%,that of parenteral nutrition group was 54.00%,and that of enteral+off-site nutrition group was higher than that of parenteral nutrition group(P<0.05).There were no significant differences in nutritional indexes,flora imbalance grade or QLQ-C30 score between the two groups before intervention(P>0.05).After the intervention,the albumin and total protein in the enteral+parenteral nutrition group were(38.76±6.02)g/L,(64.09±6.71)g/L,the number of normal microbiota disorder cases was 46,the survival time was(17.055±4.33)months,the physical function score was(74.59±7.55)points,and the emotional function score was(78.94±7.96)points,cognitive function score(88.95±9.03)points,role function score(85.49±8.61)points,social function score(81.45±8.27)points.In the parenteral nutrition group,the albumin was(34.51±5.47)g/L,the total protein was(58.91±6.55)g/L,the number of normal microbiota disorder cases was 33,the survival time was(12.48±3.59)months,the physical function score was(67.21±6.81)points,and the emotional function score was(73.55±7.78)points,cognitive function score was(83.47±8.55)points,role function score was(80.14±8.26)points,social function score was(76.93±7.827)points,and enteral+off-site nutrition group was higher than parenteral nutrition group(P<0.05).In the enteral+off-site nutrition group,the transferrin was(1.45±0.57)g/L,and there were 2 cases of class II flora dysregulation and 2 cases of class III flora dysregulation;in the off-site nutrition group,the transferrin was(1.71±0.61)g/L,and the number of class II flora dysregulation was 8 cases and the number of class III flora dysregulation was 9 cases.Enteral+off-site nutrition group was lower than parenteral nutrition group(P<0.05).ConclusionEnteral+parenteral nutrition support Enteral nutrition support can help improve the treatment effect of metastatic colorectal cancer,improve the nutritional status and survival time of patients,and improve the quality of life of patients.