目的探讨规范化的营养管理对头颈癌放疗患者营养状况的影响。方法收集2016年1月至2017年10月间四川省肿瘤医院放疗科68例头颈癌放疗患者的临床资料，按照随机数字表法分为对照组与观察组各34例，对照组给予常规营养管理，观察组提供规范化的营养管理，对比两组患者治疗期间体重、白蛋白、总淋巴细胞计数、血红蛋白以及血清前白蛋白等相关指标的变化。结果观察组放疗前、放疗4周、放疗结束后体重分别为（62.9±3.5）kg、（60.9±2.5）kg、（60.2±1.4）kg，差异具有统计学意义（F组间=9.79，P<0.001；F时间=23.71，P<0.001；F交互=16.69，P<0.001）；对照组体重分别为（62.4±3.6）kg、（58.9±2.4）kg、（56.2±1.2）kg，差异具有统计学意义（F组间=47.73，P<0.001；F时间=114.38，P<0.001；F交互=88.75，P<0.001），观察组体重丢失幅度明显低于对照组，差异有统计学意义（P<0.05）；治疗前观察组与对照组白蛋白、血清前白蛋白含量、总淋巴细胞计数、血红蛋白含量分别为（44.2±3.4）g/L、（280.1±58.5）mg/L、（1.86±0.66）×109/L、（129.8±14.1）g/L、（43.6±3.6）g/L、（273.7±49.4）mg/L、（1.89±0.84）×109/L、（140.0±12.6）g/L，放疗4周后、放疗结束时两组各指标均有所下降，观察组各血液指标下降幅度同样低于对照组，差异有统计学意义（P<0.05）；观察组治疗期间放射性口腔炎、放射性皮炎等不良反应发生率分别为5.88%、2.94%，明显低于对照组17.65%、14.71%，差异有统计学意义（P<0.05）。结论规范化的营养管理在头颈癌放疗患者营养干预中效果显著，能有效改善营养状况并降低并发症发生率。
ObjectiveTo explore the effect of standardized nutrition management on nutritional status of patients with head and neck cancer radiotherapy. Methods From January 2016 to October 2017, the clinical data of 68 patients with head and neck cancer radiotherapy were collected in Radiation Oncology Department of Sichuan Provincial Cancer Hospital. According to the random digital table methods, patients were divided into the control group （34 cases） and the observation group （34 cases） with routine nutrition management and standardized nutrition management respectively. Changes in body weight, albumin, total lymphocyte count, hemoglobin and serum prealbumin during treatment were compared between the two groups. ResultsThe body weight of the observation group measured before radiotherapy, 4 weeks of radiotherapy and after the end of radiotherapy were （62.9±3.5）kg,（60.9±2.5）kg and （60.2±1.4）kg, with statistically significant between groups （F=9.79, P<0.001； Ftime=23.71, P<0.001； Finteraction=16.69, P<0.001）,the weight in the control group was （62.4±3.6）kg,（58.9±2.4）kg and （56.2±1.2）kg, The difference was statistically significant （between groups F=47.73, P<0.001； Ftime=114.38, P<0.001； Finteraction=88.75, P<0.001）,the weight loss in the observation group was significantly lower than that of the control group （P<0.05）.Before treatment, the contents of albumin, prealbumin, total lymphocyte count and hemoglobin in the observation group and the control group were （44.2±3.4）g/L,（280.1±58.5）mg/L,（1.86±0.66）×109/L,（129.8±14.1）g/L and （43.6±3.6）g/L,（273.7±49.4）mg/L,（1.89±0.84）×109/L,（140.0±12.6）g/L. After 4 weeks of radiotherapy and at the end of radiotherapy, each index in both groups decreased, the decrease of blood indexes in the observation group was also lower than that in the control group （P<0.05）. During the treatment,the incidence of adverse reactions,such as radioactive stomatitis and radioactive dermatitis in the observation group was 5.88% and 2.94%,which was significantly lower than that of the control group（17.65% and 14.71%） （P<0.05）. Conclusion Standardized nutritional intervention plays a significant role in the comprehensive treatment of locally advanced nasopharyngeal carcinoma. It is of great significance for improving the prognosis and improving the quality of life.
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