摘要
目的探讨营养干预对子宫颈癌放化疗患者的影响。方法选取2016年10月至2018年10月山西医科大学第一医院经病理证实为子宫颈鳞状细胞癌并行放化疗的患者60例,用随机数字表法分为对照组(给予营养教育+饮食指导,30例)和干预组(依据营养评估结果给予营养干预,30例)。应用主观整体营养状况评估量表(PG-SGA)为患者进行营养评估,比较治疗过程中两组患者的营养状况、生命质量、不良反应发生情况、放化疗中断情况及血液学指标变化的差异。结果治疗过程中对照组与干预组患者中、重度营养不良的发生率分别为90%(27/30)、50%(15/30),差异有统计学意义(P<0.01)。放疗剂量达40 Gy时,干预组患者生命质量在部分功能领域、症状领域、总体健康状况方面优于对照组患者,差异均有统计学意义(均P<0.05)。对照组与干预组患者急性胃肠道反应发生率分别为96.7%(29/30)、83.3%(25/30),骨髓抑制发生率分别为96.7%(29/30)、76.7%(23/30),两组不同程度急性胃肠道反应及骨髓抑制发生率比较,差异均有统计学意义(均P<0.05)。对照组与干预组患者放疗中断率分别为26.7%(8/30)、6.7%(2/30),化疗中断率分别为56.0%(14/25)、26.9%(7/26),两组差异均有统计学意义(均P<0.05);干预组完成化疗周期数(4.38±1.10)个,多于对照组的(3.44±1.58)个。对照组与干预组患者治疗前后外周血红细胞计数、血红蛋白、清蛋白、总蛋白差值比较,差异均有统计学意义(均P<0.05),且干预组治疗后下降值均低于对照组。结论营养干预能有效提高子宫颈癌放化疗患者的营养状况、生命质量,降低不良反应发生率、放化疗中断率及血液学下降程度指标。
Objective To explore the effect of nutrition intervention on patients with cervical cancer undergoing chemoradiotherapy.Methods From October 2016 to October 2018,60 patients with cervical squamous cell carcinoma confirmed by pathology and treated with radiotherapy and chemotherapy in the First Hospital of Shanxi Medical University were selected.The subjects were randomly divided into the control group(nutrition education+dietary guidance only,30 cases)and the intervention group(nutrition intervention according to nutrition assessment results,30 cases)by random number table method.The nutrition assessment for patients was performed with patient-generated subjective global assessment(PG-SGA)scale.The changes of nutrition status,quality of life,incidence of adverse reactions,interruption status of radiotherapy and chemotherapy,and hematological indexes between the two groups in the treatment process were compared.Results The incidence of moderate and severe malnutrition in the control group and the intervention group in the treatment process was 90%(27/30)and 50%(15/30),respectively,and the difference was statistically significant(P<0.01).When the dose of radiotherapy reached 40 Gy,the quality of life of patients in the intervention group was better than that in the control group in some functional fields,symptom fields and overall health status,and the differences were statistically significant(all P<0.05).The incidence of acute gastrointestinal reaction in the control group and the intervention group was 96.7%(29/30)and 83.3%(25/30),respectively,and the incidence of bone marrow suppression was 96.7%(29/30)and 76.7%(23/30),respectively,and there were statistical differences in the incidence rates of different degrees of acute gastrointestinal reaction and bone marrow suppression between the two groups(both P<0.05).The interruption rate of radiotherapy in the control group and the intervention group was 26.7%(8/30)and 6.7%(2/30),respectively,and the interruption rate of chemotherapy was 56.0%(14/25)and 26.9%(7/26),respectively,and the differences between the two groups were statistically significant(both P<0.05).The cycles of chemotherapy completed in the intervention group were more than those in the control group[(4.38±1.10)cycles vs.(3.44±1.58)cycles].The differences of peripheral blood red blood cells count,hemoglobin,albumin,and total protein between the control group and the intervention group before and after treatment were statistically significant(all P<0.05),and the decreased values in the intervention group were lower than those in the control group.Conclusion Nutrition intervention can effectively improve the nutrition status and quality of life of patients with cervical cancer undergoing chemoradiotherapy,reduce the incidence of adverse reactions,chemoradiotherapy interruption rate and decline degree of hematological indexes.
作者
赵伟伟
张巍
高丽
南贤秀
李险峰
Zhao Weiwei;Zhang Wei;Gao Li;Nan Xianxiu;Li Xianfeng(The First Clinical Medical College of Shanxi Medical University,Taiyuan 030001,China;Department of Radiotherapy,the First Hospital of Shanxi Medical University,Taiyuan 030001,China)
出处
《肿瘤研究与临床》
CAS
2020年第5期335-340,共6页
Cancer Research and Clinic
关键词
宫颈肿瘤
放化疗
营养干预
生活质量
不良反应
Uterine cervical neoplasms
Radiation and chemotherapy
Nutrition intervention
Quality of life
Adverse reactions
