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在消化系统癌症的营养管理中,经肠道管饲和自行插入鼻胃管的可行性、可接受性及其对生活质量的影响。

Feasibility, acceptability of enteral tube feeding and self-insertion of a nasogastric tube in the nutritional management of digestive cancers, impact on quality of life.

机构信息

Unité d'Assistance Nutritionnelle, Nancy Regional University Hospital, Nancy, France.

Unité d'Assistance Nutritionnelle, Nancy Regional University Hospital, Nancy, France.

出版信息

Clin Nutr. 2020 Jun;39(6):1785-1792. doi: 10.1016/j.clnu.2019.07.017. Epub 2019 Jul 26.

DOI:10.1016/j.clnu.2019.07.017
PMID:31402277
Abstract

UNLABELLED

No study has evaluated the feasibility of enteral tube feeding (ETF) in undernourished patients with newly diagnosed gastrointestinal (GI) cancer.

OBJECTIVES

Evaluate the acceptability of ETF in patients unable to increase their dietary intake and with a weight loss >10% or albuminemia <30 g/L or BMI <18.5 before surgery, or a weight loss >5% during chemotherapy. The feasibility of self-insertion of a nasogastric tube was also assessed.

RESULTS

A total of 308 patients were nutritionally screened during a one-year period. ETF was indicated in 123 cases. Overall acceptability was 78.9% and was higher when weight loss was >10% (p < 0.0001) and before surgery (p < 0.0001), lower during chemotherapy (p < 0.0001), while not influenced by dietary intake or location of the cancer. Forty patients managed a daily self-insertion of the feeding tube (45.5%) and 48 had a nasogastric tube maintained in place. All Quality of Life (QoL) parameters were significantly improved, notably physical role functioning (+20.9% ± 24.0, p < 0.005) and mental health (+21.0% ± 17.7 p < 0.005).

CONCLUSION

According to the present algorithm, ETF was indicated in 39.9% of cases and accepted in 78.9% of newly diagnosed patients with primary GI cancer while improving QoL. This study strengthens the place of self-insertion of feeding tubes in clinical practise.

摘要

目的

评估无法增加饮食摄入且术前体重减轻>10%或血清白蛋白<30g/L或 BMI<18.5,或化疗期间体重减轻>5%的营养不良患者进行肠内管饲(ETF)的可行性。还评估了自行插入鼻胃管的可行性。

结果

在一年的时间里,对 308 名患者进行了营养筛查。123 例患者需要 ETF。总体接受率为 78.9%,当体重减轻>10%(p<0.0001)和术前(p<0.0001)时接受率更高,化疗期间(p<0.0001)时接受率更低,但不受饮食摄入或癌症部位的影响。40 名患者能够每天自行插入喂养管(45.5%),48 名患者的鼻胃管保持在位。所有生活质量(QoL)参数均显著改善,尤其是身体角色功能(+20.9%±24.0,p<0.005)和心理健康(+21.0%±17.7,p<0.005)。

结论

根据目前的算法,39.9%的初诊原发性胃肠道癌症患者需要 ETF,78.9%的患者接受了 ETF,同时改善了生活质量。这项研究加强了自行插入喂养管在临床实践中的地位。

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