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目的探讨肠内营养(EN)联合吉西他滨+顺铂(GP)方案化疗对Ⅳ期肺腺癌的临床疗效。方法将52例经病理组织细胞学检查确诊的Ⅳ期肺腺癌且采用GP方案化疗的患者随机分为研究组和对照组,每组26例。对照组依日常习惯进食,每日外周静脉用葡萄糖、20%脂肪乳、氨基酸等营养支持治疗。研究组在对照组治疗基础上,加用肠内营养素佳膳或肠内营养粉剂(TP)。分别观察两组患者的近期疗效、营养指标(血红蛋白、血清清蛋白)和临床指标。结果治疗后对照组患者部分缓解8例、稳定12例、恶化6例;研究组部分缓解9例,稳定13例、恶化4例,两组患者的近期疗效间差异无统计学意义(u=-0.512,P>0.05)。两组患者治疗前血红蛋白、血清清蛋白水平比较,差异均无统计学意义〔血红蛋白:(96±8)g/L和(98±7)g/L;血清清蛋白:(34±4)g/L和(35±4)g/L,P>0.05〕,而治疗后比较,差异均有统计学意义〔血红蛋白:(104±8)g/L和(109±7)g/L;血清清蛋白:(37±4)g/L和(38±3)g/L,P<0.05〕。两组患者电解质紊乱发生率、化疗依从率及住院时间比较,差异均有统计学意义(P<0.05),而消化道不良反应发生率比较,差异无统计学意义(P>0.05)。结论肠内营养联合GP方案化疗是治疗Ⅳ期肺腺癌安全有效的方法,可改善肺腺癌化疗患者的营养状况,提高其化疗依从性,缩短住院时间。
Objective To investigate the clinical efficacy of enteral nutrition (EN) combined with gemcitabine + cisplatin (GP) regimen in the treatment of stage Ⅳ lung adenocarcinoma. Methods Totally 52 patients with stage Ⅳ lung adenocarcinoma diagnosed by pathology and cytology were randomly divided into study group and control group with 26 patients in each group. Control group, according to daily habits of eating daily peripheral vein with glucose, 20% fat emulsion, amino acids and other nutritional support treatment. The study group in the control group based on the treatment, plus good diet enteral nutrition or enteral nutrition powder (TP). The two groups of patients were observed short-term efficacy, nutritional indicators (hemoglobin, serum albumin) and clinical indicators. Results In the control group, 8 patients were partly relieved, 12 patients were stable and 6 patients were deteriorated. In the study group, partial response was relieved in 9 patients, stable in 13 patients, and exacerbation in 4 patients. There was no significant difference in short - term efficacy between the two groups (u = 0.512, P> 0.05). There were no significant differences in hemoglobin and serum albumin levels between the two groups before treatment (hemoglobin: (96 ± 8) g / L and (98 ± 7) g / L; serum albumin: (34 ± 4) g / L and (35 ± 4) g / L, respectively, P> 0.05), and the difference was statistically significant after treatment (hemoglobin: 104 ± 8 g / L and 109 ± 7 g / Albumin: (37 ± 4) g / L and (38 ± 3) g / L, P <0.05〕. There was significant difference between the two groups in the incidence of electrolyte disturbance, the rate of chemotherapy compliance and hospital stay (P <0.05), but there was no significant difference in the incidence of gastrointestinal adverse reactions (P> 0.05). Conclusion Enteral nutrition combined with GP regimen is a safe and effective method for the treatment of stage Ⅳ adenocarcinoma of the lung, which can improve the nutritional status of patients with chemotherapy of lung adenocarcinoma, improve the compliance of chemotherapy and shorten the hospital stay.