食管癌放化疗期间营养状态及营养参数的临床意义

发布时间：2019-01-21 09:43

【摘要】：目的:评估食管癌患者放化疗期间营养状态及营养参数的临床意义。方法:前瞻性纳入同步放化疗食管癌患者68例,采用患者自评-主观全面评定量表(PG-SGA)对患者进行定期营养评估。所有患者接受早期营养教育并对重度营养不良者进行短期营养支持。根据入院时PG-SGA评分全组分为轻中度营养不良组(PG-SGA(B))和重度营养不良组(PG-SGA(C))。收集体重、白蛋白(albumin Alb)、血红蛋白(hemoglobin Hb)、白细胞(white blood cells WBC)、血小板(platelets PLT)、中性粒细胞(neutrophils NEUT)、淋巴细胞(lymphocytes LYM)、外周单核细胞(peripheral mononuclear cells PMC)等客观营养指标评估其治疗前后的临床意义。结果:PG-SGA(B)组24例,PG-SGA(C)组44例。放化疗前两组Hb和Alb没有差异(P0.05),治疗后PG-SGA(B)组Hb(x~2=2.710;P=0.009)和Alb(x~2=3.743;P=0.000)均高于PG-SGA(C)组。两组体质指数(BMI)在放化疗前后均有统计学差异(P0.05)。放化疗后PG-SGA评分与放化疗前后Hb、Alb、BMI参数的变化及体重丢失百分比呈正相关(r=0.240、0.249、0.282、0.447,P0.05)。结论:放化疗前后Hb、Alb、BMI参数的变化及体重丢失百分比是食管癌放化疗后营养风险的相关因素。重度营养不良者对营养干预依从性较好,轻中度营养不良者对营养不良认识欠佳。
[Abstract]:Objective: to evaluate the clinical significance of nutritional status and nutritional parameters in patients with esophageal cancer during radiotherapy and chemotherapy. Methods: 68 patients with esophageal cancer were prospectively enrolled in the study. The patients were assessed with self-rating-subjective comprehensive assessment scale (PG-SGA). All patients received early nutrition education and short-term nutritional support for severe malnutrition. According to the PG-SGA score at admission, the group was divided into mild and moderate malnutrition (PG-SGA (B) and severe malnutrition (PG-SGA (C). Collect body weight, albumin (albumin Alb), hemoglobin, (hemoglobin Hb), leukocytes, (white blood cells WBC), platelets, (platelets PLT), neutrophils, (neutrophils NEUT), lymphocytes (lymphocytes LYM), Objective nutritional indexes such as peripheral monocyte (peripheral mononuclear cells PMC) were used to evaluate the clinical significance before and after treatment. Results: there were 24 cases in PG-SGA (B) group and 44 cases in PG-SGA (C) group. There was no significant difference in Hb and Alb between the two groups before radiotherapy and chemotherapy (P0.05). After treatment, the Hb (xF2O2.710) and Alb (3.743 P0. 000) in the PG-SGA (B) group were higher than those in the PG-SGA (C) group. The body mass index (BMI) of the two groups was significantly different before and after chemotherapy (P0.05). The PG-SGA score after radiotherapy and chemotherapy was positively correlated with the changes of Hb,Alb,BMI parameters and the percentage of body weight loss before and after radiotherapy (r = 0.240 0 ~ 0.249 ~ 0.282 卤0.447 P 0.05). Conclusion: the changes of Hb,Alb,BMI parameters and the percentage of weight loss before and after radiotherapy and chemotherapy are related factors of nutritional risk after radiotherapy and chemotherapy for esophageal carcinoma. The patients with severe malnutrition had better compliance with nutritional intervention, and those with mild and moderate malnutrition had poor understanding of malnutrition.
【学位授予单位】：新疆医科大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R735.1

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