口服营养补充剂对胃癌患者辅助化疗期间营养状况及化疗相关毒副反应耐受性的影响

目的:探讨服用口服营养补充剂对胃癌术后患者辅助化疗期间营养状况及化疗相关毒副反应耐受性的影响。方法:回顾性分析中国人民解放军北部战区总医院肿瘤科2017年1月-2017年12月收治的胃癌术后首次接受辅助化疗的59名患者，其中28名患者自入院起即接受常规营养教育和口服肠内营养补充(ONS)且持续至化疗4周期以上作为ONS组， 31名患者仅接受常规营养饮食教育作为对照组。比较两组患者化疗前及4周期化疗后的营养状况及化疗相关不良反应严重程度。结果:两组患者化疗前一般情况、PG-SGA评分、体重指数（BMI）、血清白蛋白(ALB）水平无明显统计学差异（P＞0.05）。经过4周期化疗后，ONS组患者PG-SGA评分（12.61±1.93）低于对照组（14.84±2.21）（P＜0.05）;ONS组患者体重指数BMI（22.32±3.06）kg/m2高于对照组患者（20.49±2.91）kg/m2（P＜0.05)；ONS组患者血清白蛋白（35.36±3.89）g/L高于对照组（31.32±3.03）g/L（P＜0.05）；ONS组化疗相关骨髓抑制及消化道不良反应严重程度低于对照组（P＜0.05）。结论:口服营养补充剂可以有效改善胃癌术后患者辅助化疗期间的营养不良状态，降低化疗毒副反应严重程度，增加化疗毒副反应的耐受性。

Effect of oral nutritional supplements on nutritional status and tolerance of chemotherapy-related side effects during adjuvant chemotherapy in gastric cancer patients

Objective:To investigate the effects of oral supplements on nutritional status and chemotherapy-related side effects during adjuvant chemotherapy in gastric cancer patients.Methods:59 patients with adjuvant chemotherapy for gastric cancer admitted to the Northern Theater of the Chinese People's Liberation Army from January 2017 to December 2017 were retrospectively analysed.28 patients received routine nutrition education and Oral nutritional supplementation (ONS) from the time of admission and continued to more than 4 cycles of chemotherapy as the ONS group.31 patients only received regular nutritional diet education as a control group.The nutritional status and the severity of chemotherapy-related adverse reactions were compared between the two groups before chemotherapy and after 4 cycles of chemotherapy.Results:There were no significant differences in basic information,PG-SGA score,body mass index (BMI) and serum albumin (ALB) levels between the two groups befor chemotherapy (P>0.05).After 4 cycles of chemotherapy,the PG-SGA score (12.61±1.93) was lower in the ONS group than control group (14.84±2.21）(P＜0.05).The body mass index BMI (22.32±3.06)kg/m2 in the ONS group was higher than control group (20.49±2.91）kg/m2(P＜0.05).The serum albumin (35.36±3.89)g/L was higher in the ONS group than in the control group (31.32±3.03）g/L(P＜0.05).The chemotherapy-related bone marrow suppression and severity of gastrointestinal adverse reactions in the ONS group were lower than the control group (P＜0.05).Conclusion:ONS can improve the malnutrition status effectively during adjuvant chemotherapy in gastric cancer patients and reduce the severity of chemotherapy side effects.ONS also can increase the tolerance of chemotherapy side effects.