摘要
目的:评估营养支持治疗对神经母细胞瘤(nueroblastoma,NB)患儿临床疗效的影响。方法:纳入2014年10月至2016年12月期间在我院初诊为NB的患儿106例,分为规范营养支持治疗组(A组)52例和非规范营养支持治疗组(B组)54例,评估2组患儿初诊时营养状况,分析2组患儿在手术后、化疗后其营养学指标变化、肿瘤治疗期间并发症发生率、卫生经济学指标。结果:(1)初诊时、术后及化疗后A组患儿中上臂围分别为(8.2±2.6)、(9.5±2.2)、(9.8±2.0)cm,B组患儿分别为(7.0±2.3)、(6.5±1.4)、(6.5±1.2)cm,A组患儿三角肌皮褶厚度分别为(4.8±1.2)、(6.2±1.6)、(6.4±1.5)mm,B组患儿分别为(3.9±3.4)、(4.5±1.2)、(4.6±1.1)mm,2组间比较有统计学意义(P<0.05),A组各时间点之间比较有统计学意义(P<0.05),而B组无统计学意义(P>0.05)。(2)术后A组出现伤口裂开及感染发生率为1.9%,B组为18.5%,2组间比较有统计学意义(P<0.05)。(3)在化疗4疗程后,A组骨髓抑制、胃肠道症状以及呼吸道感染发生率明显低于B组(P<0.05)。(4)A组平均住院时间、平均住院次数、平均住院费用、非计划再入院率也明显低于B组(P<0.05)。结论:NB患儿经规范营养支持治疗后,可有效改善营养状况,降低手术、化疗带来的并发症,提高患儿对NB治疗耐受性。
Objective:To evaluate the effect of nutritional support therapy on the clinical efficacy of nueroblastoma(NB). Methods:A total of 106 children with NB admitted from October 2014 to December 2016 were enrolled and divided into the nutrition treatment group(group A,52 cases)and non-nutritional treatment group(group B,54 cases). The nutritional status of the two groups at the initial diagnosis was evaluated,and the nutritional indicators,the incidence of complications and the health economics index of the two groups after operation and chemotherapy were analyzed respectively. Results:(1)The middle upper arm circumferences of the children in group A at the initial diagnosis,after operation and after chemotherapy were(8.2±2.6),(9.5±2.2),and(9.8±2.0)cm respectively,while those in group B were(7.0±2.3),(6.5±1.4),(6.5±1.2)cm respectively. The deltoid skin fold thicknesses of the children in group A were(4.8±1.2),(6.2±1.6),(6.4±1.5)mm respectively,while those in group B were(3.9±3.4),(4.5±1.2),(4.6±1.1)mm respectively. The difference between the two groups was significant(P<0.05),and the differences among each two of the three time points in group A were also significant(P<0.05),while which in group B were not significant(P>0.05).(2)Postoperative wound dehiscence and infection complications in children were 1.9% in group A and 18.5% in group B,and the difference between the two groups was significant(P <0.05).(3)After 4 courses of chemotherapy,the incidences of myelosuppression,gastroin testinal symptoms and respiratory tract infection in group A were significantly lower than those in group B(P<0.05).(4)The average hospitalization duration,times,and cost,and the unplanned readmission rate in group A were also significantly lower than those in group B(P<0.05). Conclusion:The standardized nutrition support treatment for NB children can effectively improve the nutritional status,reduce the incidence of complications caused by surgery and chemotherapy,and improve the tolerance of children to tumor treatment.
作者
杨燕
杨娇
吕麟亚
孔粼
李长春
孔祥如
杨超
龚丽子
Yang Yah;Yang Jiao;Lu Linya;Kong Lin;Li Changchun;Kong Xiangru;Yang Chao;Gong Lizi(Department of Oncological Surgery,Children's Hospital of Chongqing Medical University, Key Laboratory of Ministry of Education for Child Development and Disorders,National and International Science and Technology Cooperation Base of the Critical Disorders in Child Development ,Key Laboratory of Chongqing City for Pediatrics)
出处
《重庆医科大学学报》
CAS
CSCD
北大核心
2019年第2期198-203,共6页
Journal of Chongqing Medical University
基金
重庆市卫生局重点资助项目(编号:2015ZDXM017)
