规范化的营养管理对头颈癌放疗患者营养状况的影响

doi:10.16689/j.cnki.cn11－9349/r.2019.04.015

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摘要目的探讨规范化的营养管理对头颈癌放疗患者营养状况的影响。方法收集2016年1月至2017年10月间四川省肿瘤医院放疗科68例头颈癌放疗患者的临床资料，按照随机数字表法分为对照组与观察组各34例，对照组给予常规营养管理，观察组提供规范化的营养管理，对比两组患者治疗期间体重、白蛋白、总淋巴细胞计数、血红蛋白以及血清前白蛋白等相关指标的变化。结果观察组放疗前、放疗4周、放疗结束后体重分别为（62.9±3.5）kg、（60.9±2.5）kg、（60.2±1.4）kg，差异具有统计学意义（F组间=9.79，P<0.001；F时间=23.71，P<0.001；F交互=16.69，P<0.001）；对照组体重分别为（62.4±3.6）kg、（58.9±2.4）kg、（56.2±1.2）kg，差异具有统计学意义（F组间=47.73，P<0.001；F时间=114.38，P<0.001；F交互=88.75，P<0.001），观察组体重丢失幅度明显低于对照组，差异有统计学意义（P<0.05）；治疗前观察组与对照组白蛋白、血清前白蛋白含量、总淋巴细胞计数、血红蛋白含量分别为（44.2±3.4）g/L、（280.1±58.5）mg/L、（1.86±0.66）×109/L、（129.8±14.1）g/L、（43.6±3.6）g/L、（273.7±49.4）mg/L、（1.89±0.84）×109/L、（140.0±12.6）g/L，放疗4周后、放疗结束时两组各指标均有所下降，观察组各血液指标下降幅度同样低于对照组，差异有统计学意义（P<0.05）；观察组治疗期间放射性口腔炎、放射性皮炎等不良反应发生率分别为5.88%、2.94%，明显低于对照组17.65%、14.71%，差异有统计学意义（P<0.05）。结论规范化的营养管理在头颈癌放疗患者营养干预中效果显著，能有效改善营养状况并降低并发症发生率。

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	李华春
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	张丹

关键词 ：规范化营养管理, 头颈癌, 放疗, 营养状况

Abstract：ObjectiveTo explore the effect of standardized nutrition management on nutritional status of patients with head and neck cancer radiotherapy. Methods From January 2016 to October 2017, the clinical data of 68 patients with head and neck cancer radiotherapy were collected in Radiation Oncology Department of Sichuan Provincial Cancer Hospital. According to the random digital table methods, patients were divided into the control group （34 cases） and the observation group （34 cases） with routine nutrition management and standardized nutrition management respectively. Changes in body weight, albumin, total lymphocyte count, hemoglobin and serum prealbumin during treatment were compared between the two groups. ResultsThe body weight of the observation group measured before radiotherapy, 4 weeks of radiotherapy and after the end of radiotherapy were （62.9±3.5）kg,（60.9±2.5）kg and （60.2±1.4）kg, with statistically significant between groups （F=9.79, P<0.001； Ftime=23.71, P<0.001； Finteraction=16.69, P<0.001）,the weight in the control group was （62.4±3.6）kg,（58.9±2.4）kg and （56.2±1.2）kg, The difference was statistically significant （between groups F=47.73, P<0.001； Ftime=114.38, P<0.001； Finteraction=88.75, P<0.001）,the weight loss in the observation group was significantly lower than that of the control group （P<0.05）.Before treatment, the contents of albumin, prealbumin, total lymphocyte count and hemoglobin in the observation group and the control group were （44.2±3.4）g/L,（280.1±58.5）mg/L,（1.86±0.66）×109/L,（129.8±14.1）g/L and （43.6±3.6）g/L,（273.7±49.4）mg/L,（1.89±0.84）×109/L,（140.0±12.6）g/L. After 4 weeks of radiotherapy and at the end of radiotherapy, each index in both groups decreased, the decrease of blood indexes in the observation group was also lower than that in the control group （P<0.05）. During the treatment,the incidence of adverse reactions,such as radioactive stomatitis and radioactive dermatitis in the observation group was 5.88% and 2.94%,which was significantly lower than that of the control group（17.65% and 14.71%）（P<0.05）. Conclusion Standardized nutritional intervention plays a significant role in the comprehensive treatment of locally advanced nasopharyngeal carcinoma. It is of great significance for improving the prognosis and improving the quality of life.

Key words： Standardized nutrition management Head and neck cancer Radiotherapy Nutritional status

基金资助:四川省干部保健科科研课题（川干研2015-801）

通讯作者: 江庆华，电子邮箱：569458942@qq.com

引用本文:

李华春，江庆华，赵吉丽，杨芮，张丹. 规范化的营养管理对头颈癌放疗患者营养状况的影响[J]. 肿瘤代谢与营养电子杂志, 2019, 6(4): 468-471.
LI Hua-chun，JIANG Qing-hua，ZHAO Ji-li，YANG Rui，ZHANG Dan. Effect of standardized nutrition management on nutritional status of patients with head and neck cancer radiotherapy. Electron J Metab Nutr Cancer, 2019, 6(4): 468-471.

1.韦燕, 张芸, 易海振. 放疗、化疗综合治疗对局部中晚期鼻咽癌患者营养状态的影响. 实用临床医药杂志. 2013；17（14）:94-96.
2.Badia T, Formiga F, Ferrer A, et al. Multifactorial assessment and targeted intervention in nutritional status among the older adults: a randomized controlled trial: the Octabaix study. BMC Geriatr. 2015；15:45.
3.余意, 黄瑜芳, 陈冬平,等. 鼻咽癌患者营养干预时机的初步研究.实用医学杂志. 2014；30（13）:2090-2092.
4.张娟,徐海声.营养干预对鼻咽癌患者放化疗疗效的影响. 实用癌症杂志. 2014；29（2）:149-151.
5.Lin QT, Tong YL, Yang L, et al. Patterns of failure and survival trends of 720 patients with stage I nasopharyngeal carcinoma diagnosed from 1990-2012: a large-scale retrospective cohort study. J Cancer. 2018；9（7）:1308-1317.
6.Rumayor Pia A, Dos Santos HT, Carlos R, et al. Epstein-Barr virus in nasopharyngeal carcinoma of guatemalan and Brazilian patients. Int J Surg Pathol. 2017；25（4）:304-309.
7.侯威,侯雪,马利新,等.早期营养干预对鼻咽癌患者放化疗后预后的影响. 中国实验诊断学. 2016；20（1）:50-52.
8.冷月婷, 沈红梅, 黄菁, 等. 鼻咽癌患者放化疗期间的营养状况及营养干预方法的研究进展. 医学研究杂志. 2017；46（7）:16-19.
9.Wang B, Wu G, Zhou Z, et al. Glutamine and intestinal barrier function. Amino Acids. 2015；47（10）:2143-2154.
10.Lee LC, Tsai AC, Wang JY. Need-based nutritional intervention is effective in improving handgrip strength and earthel index scores of older people living in a nursing home: a randomized controlled trial. Int J Nurs Stud. 2015；52（5）:904-912.
11.Lai V, Li X, Lee V, et al. Nasopharyngeal carcinoma: comparison of diffusion and perfusion characteristics between different tumour stages using intravoxel incoherent motion MR imaging. Eur Radiol. 2014；24（1）:176-183.
12.张磊, 徐巍. 鼻咽癌的治疗进展. 国际肿瘤学杂志. 2017；44（9）:693-695.
13.Luo WR, Yao KT. Cancer stem cell characteristics, ALDH1 expression in the invasive front of nasopharyngeal carcinoma. Virchows Arch. 2014；464（1）:35-43.
14.邓丹华. 营养干预对鼻咽癌同步放化疗患者的应用效果. 中国卫生标准管理. 2019；10（8）:1-3.
15.Wanden-berqhe C, Sanz-valero J, Arroyo-Sebastián A, et al. Effects of a nutritional intervention in a fast-track program for a colorectal cancer, surgery: systematic review. Nutr Hosp. 2019；33（4）:402.
16.Chaix A, Zarrinpar A, Miu P, et al. Time-restricted feeding is a preventative and therapeutic intervention against diverse nutritional challenges. Cell Metab. 2014；20（6）:991-1005.
17.中国抗癌协会, 中国抗癌协会肿瘤营养与支持治疗专业委员会, 中国抗癌协会肿瘤康复与姑息治疗专业委员会, 等. 鼻咽癌营养治疗专家共识. 肿瘤代谢与营养电子杂志. 2018；5（1）:30-32.
18.Moleres A, Milagro FI, Marcos A, et al. Common variants in genes related to lipid and energy metabolism are associated with weight loss after an intervention in overweight/obese adolescents. Nutr Hosp. 2014；30（1）:75-83.
19.Abad TO, Sarni RO, Silva SG, et al. Nutritional intervention in patients with juvenile systemic lupus erythematosus: protective effect against the increase in fat mass. Rheumatol Int. 2018；38（6）:985-992.
20.Kim E, Kang H, Kim N. Effects of nutritional intervention in long-term care in Korea. J Gerontol Nurs. 2017；43（2）:55-64.
21.Kim SH, Lee JH, Ly SY. Children with atopic dermatitis in Daejeon, Korea: individualized nutrition intervention for disease severity and nutritional status. Asia Pac J Clin Nutr. 2016；25（4）:716-728.
22.李敏杰, 孙旭东, 申岳峰. 鼻咽癌患者放疗前营养和心理因素与放疗敏感性的关系. 临床肿瘤学杂志. 2018；23（12）:1118-1122.
23.Bell JJ, Bauer JD, Capra S, et al. Multidisciplinary, multi-modal nutritional care in acute hip fracture inpatients - results of a pragmatic intervention. Clin Nutr. 2014；33（6）:1101-1107.
24.Piovesan CH, Macagnan FE, Bodanese LC, et al. Dietary quality improvement after a short-term nutritional counseling program in individuals with metabolic syndrome. Arch Latinoam Nutr. 2014；64（2）:91-98.
25.Soto-Sánchez JP, Pavez Saldiviar NF, Bravo-Gatica JI, et al. Pilot study about the effectivity of an intervention based on games in nutritional status and muscle strength on children. Nutr Hosp. 2014；30（1）:147-152.
26.Scrimgeour AG, Condlin ML. Nutritional treatment for traumatic brain injury. J Neurotrauma. 2014；31（11）:989-999.
27.Schols AM, Ferreira IM, Franssen FM, et al. Nutritional assessment and therapy in COPD: a European respiratory society statement. Eur Respir J. 2014；44（6）:1504-1520.
28.Slentz CA, Bateman LA, Willis LH, et al. Effects of exercise training alone vs a combined exercise and nutritional lifestyle intervention on glucose homeostasis in prediabetic individuals: a randomised controlled trial. Diabetologia. 2016；59（10）:2088-2098.