CT引导下经皮胃造口术肠内营养支持对食管癌伴吞咽困难病人放疗期间营养状况的影响

发布时间：2018-03-25 11:08

本文选题：吞咽困难　切入点：放疗　出处：《肠外与肠内营养》2017年04期

【摘要】：目的:探讨CT引导下经皮胃造口术肠内营养支持对食管癌伴吞咽困难病人放疗期间营养状况的影响。方法:将放疗前行CT引导下经皮胃造口术肠内营养支持的46例食管癌伴吞咽困难病人作为观察组。同期在我院放疗中心住院经口进食的43例食管癌伴吞咽困难病人作为对照组。观察组病人每日通过胃造口管摄取所需营养,对照组的营养摄入包括经口进食和静脉输注。两组病人分别于放疗前一天、放疗结束后,由责任护士测量病人身高、体重(BW),计算体质指数(BMI);遵医嘱抽取病人清晨空腹血,测定血清白蛋白(ALB)、前白蛋白(PA)、血红蛋白(HB);并观察两组病人放疗期间急性放射性食管炎的发生率和治疗计划完成情况。结果:两组病人放疗前BW、BMI、ALB、PA、HB比较,差异无统计学意义(t分别为0.84、0.63、-1.07、-0.81、1.48,P0.05)。放疗结束后观察组病人的BW、BMI、ALB、PA、HB明显高于对照组,差异有统计学意义(t分别为3.30、4.65、6.82、43.56、31.91,P0.01)。而在放疗期间,观察组病人急性放射性食管炎的总发生率明显低于对照组,差异有统计学意义χ~2=3.971,P0.05)。此外,观察组病人治疗计划完成率显著高于对照组(χ~2=6.811,P0.01)。结论:对食管癌伴吞咽困难病人放疗期间行CT引导下经皮胃造口术,进行肠内营养支持,有利于改善病人的营养不良状况,提高病人的机体免疫功能,减少放疗期间急性放射性食管炎的发生率,保证治疗计划的顺利完成。
[Abstract]:Objective: To investigate the effect of CT guided percutaneous gastrostomy enteral nutrition support for esophageal cancer patients with dysphagia during radiotherapy of nutritional status. Methods: 46 cases of esophageal carcinoma before radiotherapy CT guided percutaneous gastrostomy enteral nutrition support in patients with dysphagia patients as the observation group in our hospital over the same period of radiotherapy. Center Hospital 43 cases of esophageal cancer by oral feeding with dysphagia patients as the control group. The patients in the observation group by gastrostomy tube daily intake of nutrients needed, the control group included nutritional intake by eating and intravenous infusion. Two groups of patients respectively on the day before radiotherapy, after radiotherapy, by the nurse patient measurement height, weight, body mass index (BW) (BMI); doctor patient fasting blood extraction, determination of serum albumin (ALB), prealbumin (PA), hemoglobin (HB); and to observe the two groups of patients during treatment of acute radiation esophagitis. The incidence and treatment schedule. Results: two groups of patients before radiotherapy, BW, BMI, ALB, PA, HB comparison, the difference was not statistically significant (t = 0.84,0.63, -1.07, -0.81,1.48, P0.05). BW, the observation group patients after radiotherapy BMI, ALB, PA, HB was significantly higher than control group. The difference was statistically significant (t = 3.30,4.65,6.82,43.56,31.91, P0.01). In the observation group during radiotherapy, patients with acute radiation esophagitis incidence was significantly lower than the control group, there was significant difference between the X ~2=3.971, P0.05). In addition, the observation group of patients treatment plan completion rate was significantly higher than the control group (~2=6.811, P0.01). Conclusion: for patients with dysphagia of esophageal carcinoma with radiotherapy underwent CT guided percutaneous gastrostomy, enteral nutrition, malnutrition can improve the patient's condition, improve the immune function of patients, reduce the acute radiation esophagitis during radiotherapy hair The rate of birth ensures the successful completion of the treatment plan.

【作者单位】：郑州大学附属肿瘤医院河南省肿瘤医院放疗中心;郑州大学附属肿瘤医院河南省肿瘤医院营养科;
【分类号】：R459.3;R735.1

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