Effect of home enteral nutrition support under remote instruction for chemotherapy patients after esophageal cancer surgery
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摘要: 目的 探讨远程指导及空肠造瘘下的居家肠内营养支持对食管癌术后化疗患者营养状况和毒副反应的影响。 方法 选取136例食管癌术后化疗患者作为研究对象,实验组(n=71)留置空肠造瘘管,对照组(n=65)未留置空肠造瘘管。对照组进行常规饮食指导,实验组在对照组的基础上制订居家肠内营养补充方案并进行远程指导,比较2组化疗期间营养状况、生化指标水平及化疗相关毒副反应发生情况。 结果 化疗后,实验组转铁蛋白(TFN)、前白蛋白(PA)、体质量指数、上臂中点周径(MAC)、血浆白蛋白(ALB)水平高于对照组,差异有统计学意义(P<0.01或P<0.05)。实验组中重度中性粒细胞减少、血小板减少发生率分别为52.1%、40.8%, 低于对照组的64.6%、58.5%, 差异有统计学意义(P<0.05)。实验组疲乏发生率为63.4%, 低于对照组的78.5%, 差异有统计学意义(P<0.05)。2组呕吐、腹泻发生率比较,差异无统计学意义(P>0.05)。 结论 食管癌术后化疗患者多数营养不良,在空肠造瘘下给予规范的居家肠内营养支持并进行远程指导,可有效改善营养状况,减少化疗毒副反应,提高患者的化疗耐受性和生活质量。Abstract: Objective To explore the effect of home enteral nutrition support under remote instruction on nutritional status and side effects of postoperative chemotherapy patients undergoing esophageal surgery. Methods A total of 136 patients with postoperative chemotherapy patients undergoing esophageal surgery were included in the study, among whom 71 patients with indwelling jejunal fistulas were selected as the experimental group and 65 patients without indwelling jejunal fistulas were selected as control group. The control group was given routine diet guidance, and the experimental group formulated home enteral nutrition supplement program based on remote guidance. The nutritional status, biochemical indicators and the occurrence of chemotherapy-related side effects of the two groups were compared. Results After chemotherapy, the levels of transferrin(TFN), prealbumin(PA), body mass index, midpoint circumference of the upper arm(MAC)and plasma albumin(ALB)in the experimental group were higher than those in the control group, and the differences were statistically significant(P< 0.01 or P< 0.05). The incidence rates of moderate and severe leukopenia and thrombocytopenia in the experimental group were lower than those in the control group(52.1% versus 64.6%, 40.8% versus 58.5%, P<0.05); the incidence of fatigue in the experimental group - was significantly lower than that in the control group(63.4% versus 78.5%, P<0.05), and there were no significant differences in the incidence rates of vomiting and diarrhea(P>0.05). Conclusion Most of the patients with chemotherapy after esophageal cancer operation are malnourished. The standard enteral nutrition support at home under the remote instruction can improve the nutritional status of patients, reduce the side effects of chemotherapy, and improve the chemotherapy tolerance and quality of life of patients.
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Keywords:
- enteral nutrition /
- esophageal cancer /
- jejunostomy /
- chemotherapeutic response /
- remote instruction
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吴晓丹, 蒋超南, 覃惠英. 食管癌术后辅助化疗患者症状困扰与应对方式的相关性研究[J]. 护理管理杂志, 2014, 14(2): 77-79. FIETKAU R, LEWITZKI V, KUHNT T, et al. A disease-specific enteral nutrition For Mula improves nutritional status and functional performance in patients with head and neck and esophageal cancer undergoing chemoradiotherapy: results of a randomized, controlled, multicenter trial[J]. Cancer, 2013, 119(18): 3343-3353.
何晓琴, 陈志明, 程鹏, 等. 食管癌术后肠内营养支持的临床效果及其耐受性观察[J]. 中华全科医学, 2016, 14(6): 959-961. ANDO N, KATO H, IGAKI H, et al. A randomized trial comparing postoperative adjuvant chemotherapy with cisplatin and 5-fluorouracil versus preoperative chemotherapy for localized advanced squamous cell carcinoma of the thoracic esophagus(JCOG9907)[J]. Ann Surg Oncol, 2012, 19(1): 68-74.
岳庆峰, 魏祥志. 食管癌病人手术后早期肠内营养研究进展[J]. 肠外与肠内营养, 2016, 23(2): 120-123. 刘欣, 张鹏, 陈渊. 肠内营养支持在食管癌术后辅助化疗患者中的临床应用[J]. 天津医科大学学报, 2017, 23(3): 274-276. 罗静, 曹影婕, 眭文洁, 等. 微视频联合情境体验健康教育方案在空肠造瘘带管出院患者中的应用[J]. 中华护理杂志, 2018, 53(12): 1478-1481. 罗湘玉, 郭家龙, 张军. 免疫营养在食管癌术后应用进展[J]. 浙江临床医学, 2016(6): 1164-1166. MCCLAVE S A, TAYLOR B E, MARTINDALE R G, et al. Guidelines for the provision and assessment of nutrition support therapy in the adult critically ill patient: society of critical care medicine(SCCM)and American society for parenteral and enteral nutrition(A. S. P. E. N. )[J]. JPEN J Parenter Enteral Nutr, 2016, 40(2): 159-211.
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