食管癌患者行免疫治疗构建胃肠道+系统营养支持干预的临床效果

Clinical effect of gastrointestinal combined with systemic nutritional support on patients with esophageal cancer undergoing immunotherapy

目的 观察食管癌免疫治疗期间构建并应用胃肠道联合系统营养支持干预的临床效果。方法 收治接受免疫治疗的食管癌患者共130例为研究对象,纳入时间为2021年1~12月,所有患者以数字表法随机分为观察组和对照组,每组65例。对照组实施常规管理,观察组以常规管理为基础构建胃肠道+系统营养支持干预。比较不同干预方案下2组食管癌患者免疫治疗期间胃肠道不良反应发生情况、营养状况、生活质量及满意度差异。结果 观察组食管癌患者腹泻发生率及脱水严重程度较对照组更低,腹泻持续时间比对照组更短,平均大便次数比对照组更少(均P<0.05);干预前2组食管癌患者的BMI、PG-SGA评分、营养学指标(血清白蛋白、血红蛋白与转铁蛋白)、生活质量评分均未见明显差异(P>0.05),干预后2组食管癌患者BMI均下降,且观察组比对照组更低,PG-SGA评分、营养学指标与生活质量评分均增高,且观察组比对照组更高(均P<0.05);观察组食管癌患者对管理方案的满意度评分比对照组更高(P<0.05)。结论 食管癌免疫治疗期间构建并应用胃肠道+系统营养支持干预方案能够改善患者的腹泻症状,提高营养水平,降低疲乏发生率,提高患者生活质量与满意度。

Objective To observe the clinical effect of gastrointestinal combined with systemic nutritional support on patients with esophageal cancer undergoing immunotherapy.Methods A total of 130 patients with esophageal cancer who received immunotherapy in our hospital were selected as the objects of this study from January 2021 to December 2021.All patients were randomly divided into two groups by numerical table method:observation group(65 cases)and control group(65 cases).The control group implemented routine management,while the observation group constructed gastrointestinal combined with systemic nutrition support intervention based on routine management.The incidence of gastrointestinal adverse events,nutritional status,quality of life and satisfaction were compared between groups.Results Significantly lower incidences of diarrhea and the severity of dehydration,shorter duration of diarrhea and lower average frequency of defecation were detected in the observation group than the control group(all P<0.05).Before intervention,there were no significant differences in the body mass index(BMI),the Patient-Generated Subjective Global Assessment(PG-SGA)score,nutritional indexes(serum albumin,hemoglobin and transferrin)and quality of life score between the two groups.After intervention,significantly decreased BMI and increased PG-SGA score,nutritional indexes and quality of life score were detected in both groups,which were significantly pronounced in the observation group(all P<0.05).The satisfaction score in the observation group was significantly higher than the control group(P<0.05).Conclusion The construction and application of gastrointestinal combined with systemic nutrition support intervention during the immunotherapy of esophageal cancer can alleviate the diarrhea symptoms,improve the nutritional level,reduce the incidence of fatigue,and enhance the quality of life and satisfaction.