中华临床营养杂志
中華臨床營養雜誌
중화림상영양잡지
CHINESE JOURNAL OF CLINICAL NUTRITION
2013年
2期
72-76
,共5页
营养支持%化疗%老年%消化道恶性肿瘤
營養支持%化療%老年%消化道噁性腫瘤
영양지지%화료%노년%소화도악성종류
Nutrition support%Chemotherapy%Elderly%Gastrointestinal cancer
目的 探讨肠内联合肠外营养支持对老年晚期消化道恶性肿瘤化疗的影响.方法 将2006年至2011年本院肿瘤内科收治的79例老年晚期消化道恶性肿瘤患者采用随机数字表法分为两组,治疗组(n=42)采用营养支持联合化疗,对照组(n=37)采用单纯化疗,入院后行营养风险筛查,2个化疗周期后比较营养状态、Karnofsky功能状态评分、毒性反应、院内感染率的变化.结果 两个周期化疗后,治疗组的体重指数[(19.00 ±3.31) kg/m2比(18.24± 1.98) kg/m2,P=0.04]、白蛋白[(33.90±1.50) g/L比(29.90 ±2.38) g/L,P=0.02]、前白蛋白[(28.19±1.50) g/L比(25.51±8.38)g/L,P=0.01]、血红蛋白[(107.0±6.90) g/L比(104.20±9.70) g/L,P=0.02]、淋巴细胞[(2.99±0.55) ×109/L比(2.63±0.20) ×109/L,P=0.03]均显著升高.化疗不良反应方面,治疗组骨髓抑制发生率明显低于对照组(28.57％比83.78％,P=0.00)；治疗组中有营养风险者的骨髓抑制发生率为31.03％,显著低于对照组的95.45％ (P=0.00),其他毒性反应差异无统计学意义.治疗组两次化疗后的院内感染发生率均显著低于对照组(0比10.81％,P=0.03；2.38％比27.03％,P=0.02).结论 老年晚期消化道恶性肿瘤患者化疗期间联合应用肠内加肠外营养支持有利于机体营养状况及体能的改善,减轻毒性反应,是院内感染发生的保护性因素.营养支持符合化疗患者的需求,具有安全、有效、合理的特点.
目的 探討腸內聯閤腸外營養支持對老年晚期消化道噁性腫瘤化療的影響.方法 將2006年至2011年本院腫瘤內科收治的79例老年晚期消化道噁性腫瘤患者採用隨機數字錶法分為兩組,治療組(n=42)採用營養支持聯閤化療,對照組(n=37)採用單純化療,入院後行營養風險篩查,2箇化療週期後比較營養狀態、Karnofsky功能狀態評分、毒性反應、院內感染率的變化.結果 兩箇週期化療後,治療組的體重指數[(19.00 ±3.31) kg/m2比(18.24± 1.98) kg/m2,P=0.04]、白蛋白[(33.90±1.50) g/L比(29.90 ±2.38) g/L,P=0.02]、前白蛋白[(28.19±1.50) g/L比(25.51±8.38)g/L,P=0.01]、血紅蛋白[(107.0±6.90) g/L比(104.20±9.70) g/L,P=0.02]、淋巴細胞[(2.99±0.55) ×109/L比(2.63±0.20) ×109/L,P=0.03]均顯著升高.化療不良反應方麵,治療組骨髓抑製髮生率明顯低于對照組(28.57％比83.78％,P=0.00)；治療組中有營養風險者的骨髓抑製髮生率為31.03％,顯著低于對照組的95.45％ (P=0.00),其他毒性反應差異無統計學意義.治療組兩次化療後的院內感染髮生率均顯著低于對照組(0比10.81％,P=0.03；2.38％比27.03％,P=0.02).結論 老年晚期消化道噁性腫瘤患者化療期間聯閤應用腸內加腸外營養支持有利于機體營養狀況及體能的改善,減輕毒性反應,是院內感染髮生的保護性因素.營養支持符閤化療患者的需求,具有安全、有效、閤理的特點.
목적 탐토장내연합장외영양지지대노년만기소화도악성종류화료적영향.방법 장2006년지2011년본원종류내과수치적79례노년만기소화도악성종류환자채용수궤수자표법분위량조,치료조(n=42)채용영양지지연합화료,대조조(n=37)채용단순화료,입원후행영양풍험사사,2개화료주기후비교영양상태、Karnofsky공능상태평분、독성반응、원내감염솔적변화.결과 량개주기화료후,치료조적체중지수[(19.00 ±3.31) kg/m2비(18.24± 1.98) kg/m2,P=0.04]、백단백[(33.90±1.50) g/L비(29.90 ±2.38) g/L,P=0.02]、전백단백[(28.19±1.50) g/L비(25.51±8.38)g/L,P=0.01]、혈홍단백[(107.0±6.90) g/L비(104.20±9.70) g/L,P=0.02]、림파세포[(2.99±0.55) ×109/L비(2.63±0.20) ×109/L,P=0.03]균현저승고.화료불량반응방면,치료조골수억제발생솔명현저우대조조(28.57％비83.78％,P=0.00)；치료조중유영양풍험자적골수억제발생솔위31.03％,현저저우대조조적95.45％ (P=0.00),기타독성반응차이무통계학의의.치료조량차화료후적원내감염발생솔균현저저우대조조(0비10.81％,P=0.03；2.38％비27.03％,P=0.02).결론 노년만기소화도악성종류환자화료기간연합응용장내가장외영양지지유리우궤체영양상황급체능적개선,감경독성반응,시원내감염발생적보호성인소.영양지지부합화료환자적수구,구유안전、유효、합리적특점.
Objective To study the value of combined parenteral and enteral nutrition support with chemotherapy for advanced gastrointestinal cancer in elder patients.Methods Totally 79 patients admitted from 2006 to 2011 were randomly divided into two groups using random number table:the treatment group (n=42) was provided with combined parenteral and enteral nutrition support and chemotherapy,the control group(n =37) was treated with chemotherapy only.Nutritional risks were screened at admission.After two cycles of chemotherapy,the nutritional status,Karnofsky performance score,toxic reaction,and nosocomial infection rate were compared betweeen these two groups.Results After 2 cycles of chemotherapy,the body mass index[(19.00±3.31) kg/m2 vs.(18.24±1.98) kg/m2,P=0.04],albumin [(33.90±1.50) g/Lvs.(29.90±2.38) g/L,P=0.02],prealbumin [(28.19±1.50) g/Lvs.(25.51 ±8.38) g/L,P=0.01],hemoglobin [(107.0 ± 6.90) g/L vs.(104.20 ± 9.70) g/L,P =0.02],and lymphocyte levels [(2.99 ±0.55) × 109/L vs.(2.63 ±0.20) × 109/L,P =0.03] were all significantly higher in the treatment group.The incidence of myelosuppression in the treatment group was 28.57％,significantly lower than that in the control group (83.78％,P =0.00) ; such difference was also detected in patients with nutritional risk in the 2groups (31.03％ vs.95.45％,P =0.00).The incidences of nosocomial infection in the treatment group were significantly lower than in the control group after both the first and the second cycle of chemotherapy (0 vs.10.81％,P=0.03; 2.38％ vs.27.03％,P=0.02).Conclusions Combined enteral and parenteral nutrition support with chemotherapy in elderly patients with advanced gastrointestinal caner could improve nutritional status,reduce toxic reaction,and prevent nosocomial infection.Therefore combined nutrition support is a safe and effective approach for elderly patients with advanced gastrointestinal cancer.
