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《天津医科大学学报》[ISSN:1006-8147/CN:12-1259/R]

卷:

25卷

期数:

2019年03期

页码:

256-259

栏目:

临床医学

出版日期:

2019-05-20

文章信息/Info

Title:

Application of enteral nutrition in patients with esophageal cancer after radiotherapy and chemotherapy

文章编号:

1006-8147(2019)03-0256-04

作者:

张仲汇1; 王勇强2

（1.天津医科大学研究生院，天津300070； 2.天津医科大学一中心临床学院ICU，天津 300192）

Author(s):

ZHAN Zhong-hui1;  WANG Yong-qiang2

（1.Graduate School, Tianjin Medical University ,Tianjin 300070, China; 2. ICU,The First Central Clinical College of Medical University of Tianjin, Tianjin 300192,China)

关键词:

肠内营养; 同步放化疗; 食管癌

Keywords:

radiochemotherapy;  esophageal carcinoma;  enteral nutrition

分类号:

R735.1

DOI:

-

文献标志码:

A

摘要:

目的：探讨肠内营养能否影响同步放化疗的食管癌患者的营养状况、放化疗反应及疗效。方法：系统收集2015年1月—2018年1月在天津市天津医院进行的所有食管癌患者的资料，根据纳入和排除标准，将纳入患者随机分为两组：营养组（肠内营养+放化疗）和对照组（单纯放化疗），对照组化疗方案为顺铂（DDP），剂量为75 mg/m2，静滴，d1；氟尿嘧啶（5-FU）剂量为750 mg/m2，连续静滴d1~4，28 d为 1 周期及同步放疗。营养组在化疗联合放疗的基础上根据患者的不同情况给予10~25 kal/（kg.d）的肠内营养，在给予营养过程中根据患者进食情况、体质量变化和营养状况对营养方案相应调整。最终观察营养指标、疗效及放化疗毒副反应。结果：营养组和对照组在治疗前的一般情况、营养指标（如体质量变化、血红蛋白、血清白蛋白等）、PG-SGA 评分无统计学意义，两组在治疗后，营养组（2.44±0.31）kg体质量丢失明显少于对照组（5.30±0.32）kg，营养组血红蛋白（12.91±5.20） g/L及血清白蛋白（4.14±1.91） g/L丢失明显少于对照组[（21.33±8.06） g/L，（9.36±2.03） g/L]，但淋巴细胞总计数两组间无统计学意义。营养组客观缓解率为 83.3%，对照组客观缓解率为 77.8%。营养组与对照组相比客观缓解率差异无统计学意义（P ＞ 0.05）。营养组比对照组骨髓抑制明显改善（31.1% vs. 45.7%， P ＜ 0.05）。放射性食管炎和急性放射性肺炎发生率两组间差异无统计学意义（P＞ 0.05）。结论：肠内营养通过提高患者的营养状态，降低同步放化疗的食管癌患者的体质量丢失，提高患者对放化疗的治疗耐受。

Abstract:

Objective: To evaluate the effect of enteral nutrition(EN) on the efficacy, nutritional status and radiochemical side effects in patients with esophageal cancer after concurrent radiotherapy and chemotherapy. Methods：Data of all esophageal cancer patients in Tianjin Hospital from January 2015 to January 2018 were collected systematically. According to exclusion and inclusion criteria, patients were randomly divided into two groups: nutrition group (enteral nutrition + radiotherapy and chemotherapy) and control group(simple radiotherapy and chemotherapy). In the control group, the dosage of DDP was 75 mg/m2, intravenous drip, d1, 5-FU 750 mg/m2, continuous intravenous drip was d1~4, and cycle and synchronous radiotherapy was 28 days. Nutrition group was given 10~25 kal/(kg. d) enteral nutrition on the basis of chemotherapy combined with radiotherapy. Finally, the nutritional indicators, efficacy and toxicity of radiotherapy and chemotherapy were observed. Results: There were no significant differences in general condition, nutritional index(such as body weight change, hemoglobin, serum albumin, etc.) and PG-SGA score between nutrition group and control group before treatment. After treatment, the loss of body weight (2.44±0.31) kg in nutrition group was significantly lower than that in control group(5.30±0.32) kg, the loss of hemoglobin (12.91±5.20) g/L and albumin (4.14±1.91) g/L in nutrition group was significantly less than that in control group (21.33±8.06 g/L; 9.36±2.03 g/L), but the total lymphocyte count was not statistically significant. The objective remission rate was 83.3% in the nutrition group and 77.8% in the control group. There was no significant difference in the objective remission rate between the nutrition group and the control group(P >0.05). The blood toxicity of the nutrition group was significantly improved compared with that of the control group(31.1% vs. 45.7%, P <0.05). There was no significant difference in incidence of radiation esophagitis and acute radiation pneumonitis between the two groups (P >0.05). Conclusion: Enteral nutrition improves patients’ nutritional status and reduces weight loss of esophageal patients undergoing concurrent radiotherapy and chemotherapy, and may also enhance their tolerance to radiotherapy and chemotherapy.

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备注/Memo

备注/Memo:

作者简介 张仲汇（1981-），男，硕士在读，研究方向：急诊医学；通信作者：王勇强，E-mail: zzh981317@163.com。

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更新日期/Last Update: 2019-07-03