围手术期肠内营养支持对舌癌患者营养状况及生存质量的影响
|
摘要
目的:研究围手术期肠内营养支持对舌癌患者营养状况及生存质量的影响。方法:将86例舌癌患者随机分为实验组和对照组。除常规治疗外,实验组给予均衡型全营养素进行鼻饲或口服,对照组自备流质饮食。比较患者在入组及2周后的体成分、白蛋白、前白蛋白等营养指标变化,腹胀、腹泻、恶心及呕吐等营养支持并发症发生率,伤口感染及口咽颈瘘发生情况,生存质量、焦虑及抑郁评分。结果:治疗2周后,实验组白蛋白、前白蛋白、肌肉量、去脂体重量明显高于对照组,伤口感染、口咽颈瘘发生,焦虑及抑郁评分明显低于对照组。结论:均衡型的肠内营养制剂对舌癌患者具有良好的效果,可明显改善患者的营养状况,降低手术后并发症的发生率,并可提高患者生活质量,减轻焦虑、抑郁等精神症状,具有临床推广使用的价值。
Objective: To study the effect of perioperative enteral nutrition support on nutritional status and quality of life in patients with tongue cancer. Methods: 86 patients with tongue cancer were randomly divided into experimental group and control group. In addition to routine treatment,the experimental group was given a balanced total nutrient for nasal feeding or oral administration,and a liquid diet was provided for control group. To compare the changes of nutritional indices such as body composition,albumin and prealbumin after 2 weeks in patients,and the incidence of nutritional support complications such as bloating,diarrhea,nausea and vomiting,wound infection,and oropharyngeal fistula occurrence,quality of life score,anxiety and depression score. Results: After 2 weeks of treatment,albumin,prealbumin,muscle mass and fat-free weight were significantly higher than those in the control group,and wound infection,oropharyngeal fistula,anxiety and depression scores were significantly lower than those in the control group.Conclusion: The balanced enteral nutrition preparation has good effect on the patients with tongue cancer,it can obviously improve the nutritional status of patients,reduce the incidence of postoperative complications,and improve the quality of life,reduce anxiety,depression and other mental symptoms,with the value of clinical promotion.
Objective: To study the effect of perioperative enteral nutrition support on nutritional status and quality of life in patients with tongue cancer. Methods: 86 patients with tongue cancer were randomly divided into experimental group and control group. In addition to routine treatment,the experimental group was given a balanced total nutrient for nasal feeding or oral administration,and a liquid diet was provided for control group. To compare the changes of nutritional indices such as body composition,albumin and prealbumin after 2 weeks in patients,and the incidence of nutritional support complications such as bloating,diarrhea,nausea and vomiting,wound infection,and oropharyngeal fistula occurrence,quality of life score,anxiety and depression score. Results: After 2 weeks of treatment,albumin,prealbumin,muscle mass and fat-free weight were significantly higher than those in the control group,and wound infection,oropharyngeal fistula,anxiety and depression scores were significantly lower than those in the control group.Conclusion: The balanced enteral nutrition preparation has good effect on the patients with tongue cancer,it can obviously improve the nutritional status of patients,reduce the incidence of postoperative complications,and improve the quality of life,reduce anxiety,depression and other mental symptoms,with the value of clinical promotion.
引文
[1]Chen W,Zheng R,Baade PD,et al.Cancer statistics in China,2015[J].CA Cancer J Clin,2016,66(2):115-132.
[2]Ahmed SQ,Junaid M,Awan S,et al.Frequency of cervical nodal metastasis in early-stage squamous cell carcinoma of the tongue[J].International Archives of Otorhinolaryngology,2018,22(2):136-140.
[3]Ghantous Y,Abu EI.Global incidence and risk factors of oral cancer[J].Harefuah,2017,156(10):645-649.
[4]Cracchiolo JR.Patterns of recurrence in oral tongue cancer with perineural invasion[J].Head Neck,2018,40(6):1287-1295.
[5]Sahin B.Prognostic factors of recurrence and neck metastasis in oral carcinomas[J].Pak J Med Sci,2016,32(6):1553-1556.
[6]CSCO Expert Committee on Tumor Nutrition Therapy.A consensus among experts in nutritional therapy for patients with malignant tumors[J].Chinese Clinical Oncology,2012,17(01):59-73.[CSCO肿瘤营养治疗专家委员会.恶性肿瘤患者的营养治疗专家共识[J].临床肿瘤学杂志,2012,17(01):59-73.]
[7]Gellrich NC,Handschel J,Holtmann H,et al.Oral cancer malnutrition impacts weight and quality of life[J].Nutrients,2015,7(4):2145-2160.
[8]Greaves JR.Head and neck cancer tumor seeding at the percutaneous endoscopic gastrostomy site[J].Nutr Clin Pract,2018,33(1):73-80.
[9]Laraway DC,SN Rogers.A structured review of journal articles reporting outcomes using the university of washington quality of life scale[J].Br J Oral Maxillofac Surg,2012,50(2):122-131.
[10]Mangold AR,Torgerson RR,Rogers RR.Diseases of the tongue[J].Clin Dermatol,2016.34(4):458-469.
[11]Li W.Safety and efficacy of total parenteral nutrition versus total enteral nutrition for patients with severe acute pancreatitis:A Meta-analysis[J].J Int Med Res,2018,46(9):3948-3958.
[12]Mc Clave SA,Taylor BE,Martindale RG,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].J Parenter Enteral Nutr,2016,40(2):159-211.
[13]Blaser AR,Starkopf J,Alhazzani W,et al.Early enteral nutrition in critically ill patients:ESICM clinical practice guidelines[J].Intens Care Med,2017,43(3):380-398.
[14]Li J,Mou LJ,Wang JS,et al.Application of short peptide enteral nutrition preparation in perioperative period[J].Chinese Journal of Current Advances in General Surgery,2016,19(04):323-325.[李军,牟林军,王金申,等.短肽型肠内营养制剂在围手术期的应用[J].中国现代普通外科进展,2016,19(04):323-325.]
[15]Cheng WH,Lu MS,Guo HL,et al,Research progress on early enteral nutrition feeding intolerance in critically ill patients[J].Chinese Journal of Nursing,2017,52(01):98-102.[程伟鹤,鲁梅珊,郭海凌,等.危重症患者早期肠内营养喂养不耐受的研究进展[J].中华护理杂志,2017,52(01):98-102.]
[16]Zhao Y,Xiang JZ,Liu FY.Assessment of life quality of for patients after tongue reconstruction with radial forearm free flap,anterolateral thigh perforator flap or submental island flap[J].Shanghai Journal of Stomatology,2017,26(1):111-114.
[2]Ahmed SQ,Junaid M,Awan S,et al.Frequency of cervical nodal metastasis in early-stage squamous cell carcinoma of the tongue[J].International Archives of Otorhinolaryngology,2018,22(2):136-140.
[3]Ghantous Y,Abu EI.Global incidence and risk factors of oral cancer[J].Harefuah,2017,156(10):645-649.
[4]Cracchiolo JR.Patterns of recurrence in oral tongue cancer with perineural invasion[J].Head Neck,2018,40(6):1287-1295.
[5]Sahin B.Prognostic factors of recurrence and neck metastasis in oral carcinomas[J].Pak J Med Sci,2016,32(6):1553-1556.
[6]CSCO Expert Committee on Tumor Nutrition Therapy.A consensus among experts in nutritional therapy for patients with malignant tumors[J].Chinese Clinical Oncology,2012,17(01):59-73.[CSCO肿瘤营养治疗专家委员会.恶性肿瘤患者的营养治疗专家共识[J].临床肿瘤学杂志,2012,17(01):59-73.]
[7]Gellrich NC,Handschel J,Holtmann H,et al.Oral cancer malnutrition impacts weight and quality of life[J].Nutrients,2015,7(4):2145-2160.
[8]Greaves JR.Head and neck cancer tumor seeding at the percutaneous endoscopic gastrostomy site[J].Nutr Clin Pract,2018,33(1):73-80.
[9]Laraway DC,SN Rogers.A structured review of journal articles reporting outcomes using the university of washington quality of life scale[J].Br J Oral Maxillofac Surg,2012,50(2):122-131.
[10]Mangold AR,Torgerson RR,Rogers RR.Diseases of the tongue[J].Clin Dermatol,2016.34(4):458-469.
[11]Li W.Safety and efficacy of total parenteral nutrition versus total enteral nutrition for patients with severe acute pancreatitis:A Meta-analysis[J].J Int Med Res,2018,46(9):3948-3958.
[12]Mc Clave SA,Taylor BE,Martindale RG,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].J Parenter Enteral Nutr,2016,40(2):159-211.
[13]Blaser AR,Starkopf J,Alhazzani W,et al.Early enteral nutrition in critically ill patients:ESICM clinical practice guidelines[J].Intens Care Med,2017,43(3):380-398.
[14]Li J,Mou LJ,Wang JS,et al.Application of short peptide enteral nutrition preparation in perioperative period[J].Chinese Journal of Current Advances in General Surgery,2016,19(04):323-325.[李军,牟林军,王金申,等.短肽型肠内营养制剂在围手术期的应用[J].中国现代普通外科进展,2016,19(04):323-325.]
[15]Cheng WH,Lu MS,Guo HL,et al,Research progress on early enteral nutrition feeding intolerance in critically ill patients[J].Chinese Journal of Nursing,2017,52(01):98-102.[程伟鹤,鲁梅珊,郭海凌,等.危重症患者早期肠内营养喂养不耐受的研究进展[J].中华护理杂志,2017,52(01):98-102.]
[16]Zhao Y,Xiang JZ,Liu FY.Assessment of life quality of for patients after tongue reconstruction with radial forearm free flap,anterolateral thigh perforator flap or submental island flap[J].Shanghai Journal of Stomatology,2017,26(1):111-114.