阶梯式膳食管理模式在晚期食管癌化疗中的应用研究

The Application of Stepped Dietary Management Model in Chemotherapy for Patients with Advanced Esophageal Cancer

目的探讨阶梯式膳食管理模式在晚期食管癌患者化疗中的应用效果。方法选取2021年10月至2023年10月在本院收治的晚期食管癌患者92例,按随机数字表法分为对照组(n=46)和观察组(n=46),对照组接受常规护理,观察组接受阶梯式膳食管理模式。分别于化疗前、化疗2周、化疗4周采用生化分析仪检测血清ALB、Hb水平,PG-SGA评分评估患者营养情况,并统计两组干预期间出现的不良反应。结果化疗前两组ALB、Hb水平比较差异无统计学意义(P>0.05),化疗2周、化疗4周两组ALB、Hb水平均较化疗前比较差异有统计学意义(P<0.05),且组间比较两组ALB、Hb水平比较差异有统计学意义(P<0.05);化疗前两组PG-SGA评分比较差异无统计学意义(P>0.05),化疗2周、化疗4周两组PG-SGA评分均较化疗前比较差异有统计学意义(P<0.05),且组间比较两组PG-SGA评分比较差异有统计学意义(P<0.05);观察组骨髓抑制<Ⅲ度比例、放射性食管炎<2级比例均高于对照组,差异有统计学意义(P<0.05),而两组放射性皮炎比例比较差异无统计学意义(P>0.05)。结论阶梯式膳食管理模式在化疗期间可有效维持和提高患者血清ALB、Hb水平以及改善患者的营养状况,降低患者出现营养不良的风险,此外还可以减轻化疗期间的不良反应。

Objective To investigate the effect of stepped dietary management model in chemotherapy for patients with advanced esophageal cancer.Methods Ninety-two patients with advanced esophageal cancer admitted to our hospital from October 2021 to October 2023 were selected and divided into control group(n=46)and observation group(n=46)according to random number table method.The control group received routine nursing,and the observation group received stepped dietary management mode.Serum ALB and Hb levels were detected by biochemical analyzer before chemotherapy,2 weeks after chemotherapy and 4 weeks after chemotherapy,PG-SGA score was used to evaluate the nutritional status of patients,and adverse reactions occurred in the two groups during the intervention period were analyzed.Results There were no statistically significant differences in the levels of ALB and Hb between the two groups before chemotherapy(P>0.05).There were statistically significant differences in the levels of ALB and Hb between the two groups after 2 weeks and 4 weeks of chemotherapy(P<0.05),and there were statistically significant differences in the levels of ALB and Hb between the two groups(P<0.05).There was no statistically significant difference in PG-SGA scores between the two groups before chemotherapy(P>0.05),and there were statistically significant differences in PG-SGA scores between the two groups after 2 weeks and 4 weeks of chemotherapy(P<0.05),and there were statistically significant differences in PG-SGA scores between the two groups(P<0.05).The proportion of myelosuppression<Ⅲdegree and radiation esophagitis<2 grade in observation group were higher than those in control group,with statistical significance(P<0.05),but there was no statistical significance in the proportion of radiation dermatitis between two groups(P>0.05).Conclusion The stepped dietary management mode can effectively maintain and increase the serum ALB and Hb levels and improve the nutritional status of patients during chemotherapy,reduce the risk of malnutrition in patients,and alleviate the adverse reactions during chemotherapy.