个体化静脉营养治疗对不能进食晚期肿瘤患者疗效的回顾性分析

目的研究个体化静脉营养治疗对晚期不能进食肿瘤患者生存期的影响。方法选取2009年3月至2012年10月于中国医学科学院肿瘤医院综合科住院的40例不能进食晚期肿瘤患者为研究对象，其中营养支持组20例：接受个体化静脉营养治疗联合减症支持治疗；减症组20例：接受减症支持治疗。分析、比较两组生存期及治疗一个月后部分血生化指标。结果营养支持组平均生存时间为（176．7±24．0）．d，减症组平均生存时间为（58．2±15．4）d，营养支持组平均生存时间较减症组显著延长（P〈0．01），营养支持组6例患者死于恶病质，减症组13倒死于恶病质，营养支持组显著少于减症组（P〈0．05）。营养支持组一个月后体质量指数、白蛋白及淋巴细胞计数均较治疗前显著升高l（18．53±0．91）kg／m^2vs（17．83±0．75）kg／m^2、（31．31±2．88）g／Lvs（27．354-2．67）g／L、（1．78±0．40）g/L vs（1．29±0．18）g/L，P〈0．01]，而减症组一个月后体质量指数、白蛋白及淋巴细胞计数均较治疗前显著降低（17．14±1．58）kg/m^2 （18．88±1．23）kg／In2、（24．88±3．58）g／Lvs（26．99±2．79）g／L、（1．09±0．25）g/Lvs（1．49±0．23）g/L，P〈0．01）]。结论个体化静脉营兼治疗可以显著征长不能进食晚期肿瘤患者生存时间及降低恶病质死因。

Retrospective Analysis of Therapeutic Effect of Individualized TPN Treatment on Advanced Stage Cancer Patients

Objective To evaluate therapeutic effect on survival time of individualized TPN treatment on advanced stage cancer patients. Methods Forty advanced stage cancer patients adopted in Cancer Hospital of Chinese Academy of Medical Science from Mar. 2009 to Oct. 2012 were analyzed with retrospective cohort methods. Two cohorts were analyzed, one with 20 patients who received individualized TPN treatment and supportive care, while the other with 20 patients received supportive care without TPN. Survival time and sev- eral blood biochemistry markers were compared between the cohorts. Results The average survival time of patients with TPN treatment was （176.7 ＋ 24.0 ） days, longer significantly than the other cohort, which was （58.2 ＋ 15.4 ）days. （P 〈 0.01 ）. 6 pafients died from caehexia in TPN cohort, significantly less than the other cohort,which was 13 （P〈 0.05 ）. BMI, ALB and LYM levels were significantly increased after one month treatment with TPN（18.53 ±0.91）kg/m^2 vs （17.83 ±0.75）kg/m^2,（31,31 ±2.88） g/L vs （27.35±2.67 ） g/L, （ 1.78± 0.40 ） g/L vs （ 1.29 ± 0. 18 ） g/L, P 〈 0.01 ] , while decreased after one month treatment with supportive care （ 17.14 ± 1.58） kg/m^2 vs （ 18.88 ± 1.23 ） kg/m^2, （24.88 ±3.58） g/L vs （26.99 ±2.79） g/L,（1.09±0.25） g/Lvs（1.49±0.23） g/L,P〈0.01].Conclusion Individualized TPN treatment can prolong the smwival time of advanced stage caneer patients,and reduce the cause of dying from caehexia.