新辅助化疗结合肠内营养制剂支持对胃癌患者术前的影响研究

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目的探讨新辅助化疗结合肠内营养制剂支持治疗对胃癌患者免疫功能及营养状况的改善作用,为临床实施胃癌切除术做准备。方法按照就诊顺序将本院普外科收治的50例胃癌患者分为治疗组和对照组,每组各25例,对照组患者采用新辅助化疗方法(m FOLFOX6),治疗组患者在对照组基础上加用肠内营养制剂。两组患者治疗3个疗程后实施胃癌切除术。观察两组患者治疗前与治疗3个疗程后免疫指标、营养学指标改善情况及不良反应发生情况。结果治疗前两组患者CD4、CD8、CD4/CD8、自然杀伤(NK)细胞水平比较差异均无显著性(P>0.05);治疗组患者治疗前后上述指标比较差异具有显著性(P<0.05),对照组患者治疗前后上述指标差异无显著性(P>0.05);治疗组患者治疗后CD4、CD4/CD8、NK细胞水平明显高于对照组,CD8细胞水平明显低于对照组,差异均具有显著性(P<0.05);治疗前两组患者总蛋白、清蛋白、前清蛋白、转铁蛋白、血红蛋白、体重比较差异均无显著性(P>0.05);仅治疗组患者治疗前后NPS评分具有显著性差异(P<0.05),其他营养学指标差异均无显著性(P>0.05);治疗后治疗组患者总蛋白、清蛋白、前清蛋白、转铁蛋白、血红蛋白、NPS评分、体重均明显高于对照组,差异均具有显著性(P<0.05);治疗组患者食欲不振、进食哽咽、腹胀、恶心等不良反应发生率均显著低于对照组,差异均具有显著性(P<0.05)。结论胃癌患者术前采用新辅助化疗结合肠内营养制剂支持治疗有利于增强免疫水平,改善营养状况和化疗耐受性,为手术做好准备,对缓解患者病情,提高生活质量具有重要意义,值得临床推广应用。 Objective To investigate the effect of neoadjuvant chemotherapy combined with enteral nutrition support on the immune function and nutritional status of patients with gastric cancer and to prepare for the clinical implementation of gastric cancer resection. Methods According to the order of treatment, 50 cases of gastric cancer admitted to our hospital were divided into treatment group and control group, with 25 cases in each group. The patients in control group were treated with neoadjuvant chemotherapy (m FOLFOX6) Plus enteral nutrition preparations. Two groups of patients after treatment of three courses of gastric cancer resection. Two groups of patients before treatment and after treatment of three immune indicators, nutritional indicators to improve the situation and adverse reactions. Results There was no significant difference in CD4, CD8, CD4 / CD8 and NK cell levels between the two groups before treatment (P> 0.05). There was significant difference between the two groups before and after treatment (P <0.05) (P> 0.05). The levels of CD4, CD4 / CD8 and NK cells in the treatment group were significantly higher than those in the control group after treatment, and the levels of CD8 in the treatment group were significantly lower than those in the control group (P <0.05). There was no significant difference in total protein, albumin, prealbumin, transferrin and hemoglobin between the two groups before treatment (P> 0.05); only the NPS score (P <0.05). There was no significant difference in other nutritional indexes (P> 0.05). After treatment, the total protein, albumin, prealbumin, transferrin, hemoglobin, NPS score, Were significantly higher than those in the control group (P <0.05). The incidences of adverse reactions such as poor appetite, choking, abdominal distension and nausea in the treatment group were significantly lower than those in the control group (P < 0.05). Conclusion Preoperative neoadjuvant chemotherapy combined with enteral nutrition supportive therapy in patients with gastric cancer is beneficial to enhance immunity, improve nutritional status and chemotherapy tolerance, prepare for surgery and is important for alleviating patients’ condition and improving quality of life. Clinical application.
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