[家庭肠内营养在晚期胃癌患者中的应用及其对生活质量的影响]

[Application of home enteral nutrition and its impact on the quality of life in patients with advanced gastric cancer].

作者信息

Qian Zhenyuan, Sun Yuanshui, Ye Zaiyuan, Shao Qinshu, Xu Xiaodong, Xu Ji

机构信息

Department of Gastrointestinal Surgery, Zhejiang Provincial People's Hospital, Hangzhou 310014, China.

出版信息

Zhonghua Wei Chang Wai Ke Za Zhi. 2014 Feb;17(2):158-62.

PMID:24577772

Abstract

OBJECTIVE

To investigate the application of home enteral nutrition (HEN) in patients with advanced gastric cancer and its impact on the quality of life.

METHODS

Data of 60 consecutive patients with advanced gastric cancer, who could not underwent operation and had relapse metastasis, from June 2010 to June 2012 were retrospectively analyzed. According to familial nutritional pattern, these 60 patients were divided into HEN group (25 cases) receiving home enteral nutritional support and control group (35 cases). HEN patients were supported through jejunostomy tube or nasal gastric tube. Control patients were supported through total parental nutrition or purely eating respectively. All the patients received intravenous chemotherapy and evaluated by Karnofsky index and Spitzer system in the first, third, sixth and twelfth month. In the sixth month, patients were also examined by EORTC QLQ-C30.

RESULTS

No significant differences were found between the two groups according to 8 elements containing age, sex, BMI, etc. A total of 53 patients died within one year, including 21 in HEN group and 32 in control group. The Karnofsky scales showed that HEN group scored meanly 57.4, 39.6 and 28.2 in the third, sixth and twelfth month respectively, which were significantly higher than those of control group (45.3, 29.2 and 20.1, P=0.041, P=0.012 and P=0.015 respectively). The Spitzer scales showed that HEN group scored meanly 5.12, 4.04 and 2.54 on average in the third, sixth and twelfth month respectively, which were significantly higher than those of control group (4.32, 3.01 and 1.97, P=0.048, 0.035 and P=0.024 respectively). The EROTC QLQ-C30 scales showed that HEN group scored higher than control group in functional scales (P<0.05), and lower in the symptom scales of short breathing, pain and tired (P=0.025, P=0.044, P=0.036 respectively), while higher in diarrhea (P=0.047).

CONCLUSIONS

The quality of life of patients with advanced gastric cancer declines gradually with the nutritional status deteriorating. HEN can be applied to improve the nutritional status and quality of life.

摘要

目的

探讨家庭肠内营养（HEN）在晚期胃癌患者中的应用及其对生活质量的影响。

方法

回顾性分析2010年6月至2012年6月连续收治的60例无法手术且有复发转移的晚期胃癌患者资料。根据家庭营养模式，将这60例患者分为接受家庭肠内营养支持的HEN组（25例）和对照组（35例）。HEN组患者通过空肠造瘘管或鼻胃管给予营养支持。对照组患者分别通过全肠外营养或单纯进食给予支持。所有患者均接受静脉化疗，并在第1、3、6和12个月时采用卡氏评分法和斯皮策系统进行评估。在第6个月时，患者还接受了欧洲癌症研究与治疗组织生活质量核心问卷（EORTC QLQ-C30）检查。

结果

两组患者在年龄、性别、体重指数等8项因素方面无显著差异。共有53例患者在1年内死亡，其中HEN组21例，对照组32例。卡氏量表显示，HEN组在第3、6和12个月时的平均得分分别为57.4、39.6和28.2，显著高于对照组（45.3、29.2和20.1，P分别为0.041、0.012和0.015）。斯皮策量表显示，HEN组在第3、6和12个月时的平均得分分别为5.12、4.04和2.54，显著高于对照组（4.32、3.01和1.97，P分别为0.048、0.035和0.024）。EROTC QLQ-C30量表显示，HEN组在功能量表上的得分高于对照组（P<0.05），在气短、疼痛和疲劳等症状量表上的得分低于对照组（P分别为0.025、0.044和0.036），而在腹泻量表上的得分高于对照组（P=0.047）。