CAJ | 학술논문

目的：探讨留置鼻胃管注食在食管癌同步放化疗中的效果。方法选择2000年1月至2014年7月收治的经食管镜及病理证实且无远处转移的食管癌患者100例，将其随机分为观察组和对照组各50例。观察组放射治疗第1天开始选取硅胶鼻胃管（建议留置体内小于45 d）留置胃内注食流质。对照组根据饮食医嘱，给予饮食指导进食。两组食物样式、数量、次数根据患者情况而定。观察两组患者治疗期间每2周的营养指标情况，急性放射性食管黏膜损伤最早出现时间及治疗的连续性，急性放射性食管炎等级评价情况等。结果两组患者在放疗至40 Gy与60 Gy时，观察组各项营养指标与对照组比较，差异均有统计学意义（P＜0．05）。两组患者均出现程度不等的急性放射性食管黏膜损伤，观察组无一例中断放疗，对照组有8例放疗至40~45 Gy时中断放疗，中断时间5~9 d，两组因放射性食管黏膜损伤而中断放疗的病例数比较，差异有统计学意义（P＜0．05）。两组1、2级放射性食管炎的例数与3、4级放射性食管炎例数比较，差异有统计学意义（P＜0.01）。结论留置鼻胃管注食在食管癌同步放化疗中的重要性。
목적：탐토류치비위관주식재식관암동보방화료중적효과。방법선택2000년1월지2014년7월수치적경식관경급병리증실차무원처전이적식관암환자100례，장기수궤분위관찰조화대조조각50례。관찰조방사치료제1천개시선취규효비위관（건의류치체내소우45 d）류치위내주식류질。대조조근거음식의촉，급여음식지도진식。량조식물양식、수량、차수근거환자정황이정。관찰량조환자치료기간매2주적영양지표정황，급성방사성식관점막손상최조출현시간급치료적련속성，급성방사성식관염등급평개정황등。결과량조환자재방료지40 Gy여60 Gy시，관찰조각항영양지표여대조조비교，차이균유통계학의의（P＜0．05）。량조환자균출현정도불등적급성방사성식관점막손상，관찰조무일례중단방료，대조조유8례방료지40~45 Gy시중단방료，중단시간5~9 d，량조인방사성식관점막손상이중단방료적병례수비교，차이유통계학의의（P＜0．05）。량조1、2급방사성식관염적례수여3、4급방사성식관염례수비교，차이유통계학의의（P＜0.01）。결론류치비위관주식재식관암동보방화료중적중요성。
Objective To discuss the effect of indwelling nasogastric tube feeding in esophagus cancer concurrent ra-diochemotherapy. Methods Selected 100 esophagus cancer patients,who were verified by esophagoscope and pathology and had no distant metastasis,admitted from January,2000 to July,2014. Randomly divided them into observation group(n=50) and control group(n=50). Used silica gel nasogastric feeding tube(suggest indwelling in body for less than 45 d),nasogastric tube to feed fluid in stomach on 1 d of observation group′s radiotherapy. Fed control group according to doctor′s diet instruction. Both groups′food type,amount,and frequency were decided according to patients. Observed both groups′nutritive index every 2 weeks during treatment,and the first time acute radioactive esophageal mucosa damage appeared and therapeutic continuity ,and the garde evaluation of acute radiation esophagitis. Results Compared observation group′s nutritive index with control group′s when doing chemoradiotherapy 40 Gy and 60 Gy,differences showing statistical significance(P<0.05). Patients in both groups had dif-ferent degree′s acute radioactive esophagus mucosa damage. All patients in observation group kept radiotherapy ,while 8 patients in control group broke off radiotherapy for 5-9 d when doing 40-45 Gy. Compared the number of patients who broke off radiother-apy because of acute radioactive esophagus mucosa damage in both groups,differences showing statistical significance(P<0.05). Compared the number of level 1,2 radioactive oesophagitis and level 3,4 radioactive oesophagitis,differences showing statistical significance (P<0.01). Conclusion Indwelling nasogastric tube feeding is important in esophagus cancer concurrent ra-diochemotherapy.