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,P>0.05)。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,P<0.01)。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,P<0.05)。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,P<0.01)。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。
Objective： To investigate the effect of enteral nutrition support by CT-guided percutaneous gastrostomyon the nutritional status of patients with esophageal cancer complicated with dysphagia during radiotherapy. Methods： Therewere46 cases of esophageal cancer patients with dysphagia treated with CT-guided percutaneousgastrostomy. Others 43 cases of esophageal cancer by oral feeding in patients with dysphagia as control groupduringthe sametimein our hospital radiotherapy center. Patients in the observation group were ingested daily through the gastrostomy, and the nutritional intake of the control group included oral ingestion and intravenous infusion. All patients were measuredthe body height, body weight（BW）. body mass index（BMI）, Serum levels of serum albumin（ALB）, pre-albumin（PA） and hemoglobin（HB） before and after radiotherapy. We also observed the incidence of acute radiation esophagitis and the completion of the treatment plan during radiotherapy in both groups, and to observe the two groups of patients the incidence rate of radiotherapy and treatment plan during the completion of acute radiation esophagitis. Results： There was no significant difference in BW, BMI, ALB, PA, HB before radiotherapy between the two groups（t = 0.84, 0.63,-1.07,-0.81, 1.48, P〈0.05）. The BW, BMI, ALB, PA and HB of the observation group were significantly higher than those of the control group at the end of radiotherapy, which werestatistically significant（t =3.30, 4.65, 6.82, 43.56, 31.91,P〈0.01）. During the radiotherapy, the total incidence of acute radiation esophagitis in the observation group was significantly lower than that in the control group,（χ^2= 3.971, P〈0.05）. In addition, the completion rate of the observationgroup was significantly higher than that of the control group（χ^2 = 6.811, P〈0.01）. Conclusion： To the Patients with dysphagia of esophageal cancer, enteral nutrition by CT guided percutaneous gastrostomy, can improve the malnutrition, the immune function of
作者
白献红
杜平
马艳会
买轩
秦晓红
BAI Xian-hong DU Ping MA Yan-hui MAI Xuan QIN Xiao-hong(Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital,Radiation therapy center Nutrition Department, Zhengzhou 450008, Henan, China)
出处
《肠外与肠内营养》
北大核心
2017年第4期240-243,共4页
Parenteral & Enteral Nutrition
关键词
吞咽困难
放疗
CT引导
胃造口
肠内营养
Dysphagia
Radiotherapy
CT guidance
Gastrostomy
Enteral nutrition
