中华临床医师杂志（电子版）
中華臨床醫師雜誌（電子版）
중화림상의사잡지（전자판）
CHINESE JOURNAL OF CLINICIANS(ELECTRONIC VERSION)
2014年
13期
2469-2473
,共5页
高嵩涛%郑琰%蔡启卿%姚伟涛%王家强%张鹏%杜鑫辉%王鑫
高嵩濤%鄭琰%蔡啟卿%姚偉濤%王傢彊%張鵬%杜鑫輝%王鑫
고숭도%정염%채계경%요위도%왕가강%장붕%두흠휘%왕흠
骨肉瘤%营养支持%新辅助化疗%营养风险筛查%临床结局
骨肉瘤%營養支持%新輔助化療%營養風險篩查%臨床結跼
골육류%영양지지%신보조화료%영양풍험사사%림상결국
Osteosarcoma%Nutritional support%Neoadjuvant chemotherapy%Nutritional risk screening%Clinical outcome
目的：探讨联合营养支持模式对有营养风险的骨肉瘤化疗患者临床结局的影响。方法采用不同年份的队列对比研究方法，按回顾性研究计划得到两个观察组，研究组为2010年至2013年入院的符合研究标准的患者36例，入院后行营养风险筛查，评分≥3分给予联合营养支持；对照组为2007～2009年间同类患者32例，入院后行营养风险筛查，评分≥3分给予单纯肠外营养支持。比较两组患者营养代谢指标变化及感染、黏膜溃疡、骨髓抑制、消化道反应等并发症的发生率、化疗期间住院时间。结果两组患者化疗期间接受相似能量的、不同途径的营养支持前后，组内及组间患者在营养代谢指标方面变化均无统计学意义（P＞0.05）。研究组患者化疗后感染率8.33%，黏膜溃疡发生率11.11%，Ⅳ级骨髓抑制率8.33%，消化道反应发生率11.11%，住院天数（28.98±4.47） d；对照组患者化疗后感染率28.13%，黏膜溃疡发生率31.25%，Ⅳ级骨髓抑制率31.25%，消化道反应发生率31.25%，住院天数（35.23±5.29）d，研究组并发症发生率和化疗期间住院时间低于对照组，差异具有统计学意义（P＜0.05）。结论对有营养风险的骨肉瘤化疗患者采取联合营养支持模式有益于改善其临床结局。
目的：探討聯閤營養支持模式對有營養風險的骨肉瘤化療患者臨床結跼的影響。方法採用不同年份的隊列對比研究方法，按迴顧性研究計劃得到兩箇觀察組，研究組為2010年至2013年入院的符閤研究標準的患者36例，入院後行營養風險篩查，評分≥3分給予聯閤營養支持；對照組為2007～2009年間同類患者32例，入院後行營養風險篩查，評分≥3分給予單純腸外營養支持。比較兩組患者營養代謝指標變化及感染、黏膜潰瘍、骨髓抑製、消化道反應等併髮癥的髮生率、化療期間住院時間。結果兩組患者化療期間接受相似能量的、不同途徑的營養支持前後，組內及組間患者在營養代謝指標方麵變化均無統計學意義（P＞0.05）。研究組患者化療後感染率8.33%，黏膜潰瘍髮生率11.11%，Ⅳ級骨髓抑製率8.33%，消化道反應髮生率11.11%，住院天數（28.98±4.47） d；對照組患者化療後感染率28.13%，黏膜潰瘍髮生率31.25%，Ⅳ級骨髓抑製率31.25%，消化道反應髮生率31.25%，住院天數（35.23±5.29）d，研究組併髮癥髮生率和化療期間住院時間低于對照組，差異具有統計學意義（P＜0.05）。結論對有營養風險的骨肉瘤化療患者採取聯閤營養支持模式有益于改善其臨床結跼。
목적：탐토연합영양지지모식대유영양풍험적골육류화료환자림상결국적영향。방법채용불동년빈적대렬대비연구방법，안회고성연구계화득도량개관찰조，연구조위2010년지2013년입원적부합연구표준적환자36례，입원후행영양풍험사사，평분≥3분급여연합영양지지；대조조위2007～2009년간동류환자32례，입원후행영양풍험사사，평분≥3분급여단순장외영양지지。비교량조환자영양대사지표변화급감염、점막궤양、골수억제、소화도반응등병발증적발생솔、화료기간주원시간。결과량조환자화료기간접수상사능량적、불동도경적영양지지전후，조내급조간환자재영양대사지표방면변화균무통계학의의（P＞0.05）。연구조환자화료후감염솔8.33%，점막궤양발생솔11.11%，Ⅳ급골수억제솔8.33%，소화도반응발생솔11.11%，주원천수（28.98±4.47） d；대조조환자화료후감염솔28.13%，점막궤양발생솔31.25%，Ⅳ급골수억제솔31.25%，소화도반응발생솔31.25%，주원천수（35.23±5.29）d，연구조병발증발생솔화화료기간주원시간저우대조조，차이구유통계학의의（P＜0.05）。결론대유영양풍험적골육류화료환자채취연합영양지지모식유익우개선기림상결국。
ObjectiveTo explore the clinical outcome of the combined nutrition support for preoperative neoadjuvant chemotherapy osteosarcoma patients at nutritional risk.MethodsTwo research groups were obtained using a cohort sampling method. The study group including 36 osteosarcoma patients that confirmed by biopsy from 2010 to 2013, they received nutritional risk screening(NRS) 2002 after admission.Nutritional risk was defined as NRS 2002 score≥3. Patients of the study group with nutritional risk received combined nutritional support. The control group including 32 cases with pathological confirmed osteosarcoma were enrolled from 2007 to 2009. They received PN supports during chemotherapy after nutritional risk screening. Nutritional and metabolic parameters including weight, prealbumin and the function of liver and kidney, the rate of infectious complications, the rate of mucous membrane ulcer, the rate of levelⅣ bone marrow suppression, the rate of reaction of digestive tract and the duration of hospital stay were analyzed.ResultsThere were no significant difference in body weight, plasma albumin and the function of liver and kidney in these two groups of patients within and between groups that before and after received different ways of nutritional support of similar energy(P>0.05). In the study group patients after chemotherapy, the postoperative infection rate were 8.33%, the mucosal ulcer rate were 11.11%,Ⅳ myelosuppression rate were 8.33%, the gastrointestinal reactions rate were 11.11%and the duration of hospital stay were (28.98±4.47)d; In the control group patients after chemotherapy, the postoperative infection rate were 28.13%, the mucosal ulcer rate were 31.25%,Ⅳ myelosuppression rate were 31.25%, the gastrointestinal reactions rate were 31.25% and the duration of hospital stay were (35.23±5.29)d, the complication rate and the duration of hospital stay in study group were significantly lower than those in the control group(P<0.05).ConclusionFor the preoperative neoadjuvant chemotherapy osteosarcoma patients, nutritional risk screening and combined nutritional support can improvetheirclinical outcome.
