不同营养支持方式对食管癌放疗患者影响

目的 探讨食管癌放疗中管饲营养支持与非管饲营养支持对其不良反应发生率的影响。方法 选取120例有高危因素的食管癌患者,按照随机数字法分成管饲(TF)组60例和非管饲(NTF)组60例,两组均行放疗中营养干预。对比两组营养支持条件下的食管炎、骨髓抑制发生率,并观察比较肺部感染、营养状况、放疗完成等。结果 TF组≥2级食管炎发生率均低于NTF组(P<0.05);TF组1、2级骨髓抑制发生率与NTF组相相近(P>0.05),3级骨髓抑制发生率低于NTF组(P<0.05);TF组肺部感染发生率低于NTF组(P<0.05);TF组BMI、前白蛋白指标变化优于NTF组(P<0.05);TF组1例患者因4级食管炎未完成放疗,NTF组有5例未完成放疗(P<0.05);TF组住院时间平均缩短6.2 d (P<0.05)。结论 在对有高危因素的食管癌患者行放疗时,营养供给中使用管饲营养支持可以有效减少不良反应的发生率,提高治疗完成率,并缩短平均住院日。

Effect of different nutritional support methods on esophageal cancer patients receiving radiotherapy

Objective To compare the effect of nutritional support with and without tube feeding on the incidence of adverse reactions in radiotherapy for esophageal cancer. Methods A total of 120 esophageal cancer patients with high-risk factors receiving radiotherapy were selected and randomly assigned into the tube feeding (TF,n=60) and non-tube feeding groups (NTF,n=60) according to the random number method. Nutritional interventions were performed during radiotherapy in both groups. The incidence of esophagitis and myelosuppression,pulmonary infection,nutritional status and the completion of radiotherapy were observed and statistically compared between TF and NTF groups. Results In the TF group,the incidence of ≥ grade 2 esophagitis was lower than that in the NTF group. The incidence of grade 3 esophagitis significantly differed between two groups (P<0.05). The incidence of grade 1-2 myelosuppression did not differ between two groups,whereas the incidence of grade 3 myelosuppression in the TF group was significantly lower than that in the NTF group (P<0.05). In the TF group,the incidence of pulmonary infection was remarkably lower than that in the NTF group (P<0.05). The changes of BMI and prealbumin in the TF group were better than those in the NTF group (both P<0.05). One patient in the NTF group failed to complete the radiotherapy due to grade IV esophagitis,and 5 cases in the NTF group (P<0.05). In the TF group,the length of hospital stay was significantly shortened by 6.2 d on average (P<0.05). Conclusions During radiotherapy for esophageal cancer patients with high-risk factors,nutritional support with tube feeding can effectively reduce the incidence of adverse reactions,improve the completion rate of treatment,and shorten the average length of hospital stay.