230 2016 8 24 4 1 234,56-7 89 :; 丁洁云蔡晓娟陈美 <,56-2347 89:; => 2012 10? 2014 12!"#$%&' @6 100A234BC,56-7,DE F GHIJKHL 50A GHMNO 2 PQIRS,JKHTUVW XY H7,56-89Z[; (QLQ C30) \ I ] ^_,56- H7 89Z[; (QLQ C30) \ I ]^_`abc ( P> 0 05),56 - J K H 7 [(75 6±13 1) (63 8±12 4) ] [(61 9±14 3) (52 5±13 7) ] [(36 6±13 2) (45 8±15 0) ] [(34 8±16 1) (44 3±17 0) ] [(49 2±15 7) (57 2±14 3) ] 2 [(50 2±16 2) (59 0±15 8) ] [ [(21 5±10 3) (29 9±11 3) ] [(68 8±13 4) (58 2±12 8) ]\ GH ( P<0 05);,56- JKH 7 :; [(59 3±8 5)kg (54 4±7 3)kg] :; [(21 9±2 1)kg/m 2 (18 4± 2 8)kg/m 2 ] [(125 9±8 9) g/l (107 3±9 5) g/l] [(35 1± 6 9)g/L (29 0±5 3)g/L] [(213 54±37 47)mg/L (174 56±36 26)mg/L] GH ( P<0 01) <,56-2347, S, 23 2 RS, 89:;,,56-23&';,5- ;23 ;89:;; :2012#$% b ( ) (HS12947) Theefectofcomprehensiveinterventiononthequalityoflifeofesophagealcancerpatientstreatedwith radiotherapy DingJieyun,CaiXiaojuan,ChenMei. DepartmentofInternalMedicine,NantongTumor Hospital,Nantong226361,China Corespondingauthor:CaiXiaojuan,E mail:caixiaojuan1972@.126.com Abstract Objective Todiscustheefectofcomprehensiveinterventiononthequalityoflifeofesopha gealcancerpatientsreceivingradiotherapy.methods 100patientswithesophagealcarcinomatreatedwithradio therapyforthefirsttimewereselectedbetweenoctober2012anddecember2014innantongtumorhospitalin JiangsuProvinceandrandomlydividedintocontrolgroupandobservationgroup(n=50ineachgroup)witha randomnumbertable.inthecontrolgroup,routinedietaryinstruction,fluidinfusionsupportandsymptomaticin terventionwereused;comprehensiveinterventionwasaddedintheobservationgroup.scoresofcorequalityof lifequestionnaire(qlq C30)andnutritionalindexesbeforeandafterradiotherapyinthetwogroupswerecom pared.results TherewerenostatisticalysignificantdiferencesinQLQ C30scoresandnutritionalindexesbe tweenthetwogroupsbeforeradiotherapy(alp>0 05).Afterradiotherapy,thephysical[(75 6±13 1)vs. (63 8±12 4)]andemotionalfunction[(61 9±14 3)vs.(52 5±13 7)],fatigue[(36 6±13 2)vs. (45 8±15 0)],pain[(34 8±16 1)vs.(44 3±17 0)],insomnia[(49 2±15 7)vs.(57 2±14 3)], losofappetite[(50 2±16 2)vs.(59 0±15 8)],nauseaandvomiting[(21 5±10 3)vs.(29 9± DOI:10.3760/cma.j.isn.1674 635X.2016.04.008 :226361!"#$%&' ( ( )*+),,- (./) $0 :)*+,E mail:caixiaojuan1972@.126.com
2016 8 24 4 231 11 3)],generalhealthstatus[(68 8±13 4)vs.(58 2±12 8)]intheobservationgroupweresignificantly beterthaninthecontrolgroup(alp<0 05).Innutritionalstatus,bodyweight[(59 3±8 5)kgvs.(54 4± 7 3)kg],bodymasindex[(21 9±2 1) kg/m 2 vs.(18 4±2 8)kg/m 2 ],hemoglobin[(125 9± 8 9)g/Lvs.(107 3±9 5)g/L],albumin[(35 1±6 9)g/Lvs.(29 0±5 3)g/L],andprealbumin [(213 54±37 47)mg/Lvs.(174 56±36 26)mg/L]intheobservationgroupwerealhigherthanthosein thecontrolgroupafterradiotherapy(alp<0 01).Conclusion Comprehensiveinterventionforesophageal cancerpatientsreceivingradiotherapymayimprovenutritionalstatus,reduceesophagitis,thirsty,fatigue,losof appetiteandothersymptoms,improvethequalityoflife,ensurethecompletionofradiotherapy. Keywords Esophagealneoplasms;Radiotherapy;Esophagitis;Qualityoflife;Comprehensiveinter vention Fundprogram:TheProgramof2012NantongCitySocialUndertakingsScienceandTechnologyProject (Guidance)(HS12947) 234 O &', 2347 1/2 X, B [1] 23 4 &',7 C 50% 6-, U,56-23 4 6- [2] 2347,-,E,-;, 823,7 2 RS, 7, 8,7!" 2 RS,,- #< $%,& R', 7 I ()*,+,-,-Y.-,- / [3] 01 MN -, 2 RS I[, 7 S,,-#<2, 7 8 9:;, -,- 1 1 1 345 =>0 2012 10? 2014 12,- @ 6 234 6,-7 100AF1 6 DE FJKHI GHL 50A,=] 7: c 89:;BC <;6,-,, -;b F 60~70Gy; O,7 O,`9 [< =>,`? @IAB C ;Karnofsky\ (karnofskyperformancescore, KPS) 70,7 D &E 1 ]7:2346- F ;? @IAB C ;GH!1 H7 I J 6-KL KPS V045,^_` abc ( P>0 05),M ( 1) 01 NO 7 1 2 K 1 2 1 2 H,- P?,-QR, STU V 2 GHMNO 2, QW 2XY,,- D &Z[ 2 \,] PQ c ^,-! 1 H7 345 Table1 Comparisonoftwogroupsofpatientswithgeneralinformation I (_) J (A) ` (A) HJ ab x±s c $ X GH (n=50) 44~70 59 4±7 8 33 17 28 16 6 JKH (n=50) 46~70 57 9±8 6 35 15 25 18 7 χ 2 0 184 0 364 P 0 668 0 883 HJ (A) Ⅰ Ⅱ Ⅲ,-; (Gy) KPS( ) GH (n=50) 6 37 7 60~70 >70 JKH (n=50) 4 35 11 60~70 >70 χ 2 P \:KPS:karnofsky\ 1 334 0 551
232 2016 8 24 4 2 8 F 76 2%, ' 8 5% [4] F 8 X,- 8 ', T 2, - J\ PQ,,-& R HT 2 K J\ $ :(1) F 23, 2 &Q 7,D:D; : : 2,, 3F 37 ; 8 2F 2 2 \, 23 47 M> 2, 2$ 9 /, ;M> (2) 2 7 :1=, `,T,, /, b 27 B Q, T N 23 23 &,, :0 9%8 100ml 5ml 5mg, 16 U 5~10ml, 7 (3) 2 : 2 2 T23,!" 23,- JKHN#$ %&' ; N, '! JKHT GH VWXY 2 T U V 7 ( 2, ; ), N * Q 6 - + a (NCCW2009]7,),b- 1d ;,. /01 : 0 200~300ml, 2 F :/01 20g 2 :345 6 7 8 9:;, :6/ / : < / 0 1 := >? < 8 @I7,;)7 6- IA S B 2C, D B2N K, EJ7 E 7 T,-!" 3~4,5 23, 2, 7, F 3,, GF3 ;/01, 37,H ZIJ ` [KLM NVO (17) (11%) \5,, + P,J20090046] FQPQ 1 2 2 RS 7,- R8 2 RS ST F7 E I UV,W XY, V \ 7, ZT Q[ \]^, ;_ 7 \T 7, `,ab 7 I T] ^\, c A\, Q E 7 2500ml X, Q 6 / / = 1~2E, </ *< < =< ;F ' 9, $, ^,7 ',, [,B T, -,T,,& <, 1 2 3,-QR,-QR,5 23?,5 <,7 2I 2F, 2 2, 2 ; 8 F, ;,;,! b,!,.7 O89 23 RS3, ;JKH [, 7,,B 0, MN, ( 6 8 / ) (, ) A - ( ) [5],\ U V,,7 D6- /, 7 0[! E, 7!" RS, 6 1 3 JK ] 1 3 1 89:; N 4R1 6-H1, 89:;Z[ ; (EORTCQLQ C30)`,: 5E ; 3ERS ; 1E S ; I 6E RSI (S _, 15 S (89:;) 7E,\ 1~7 ; \ 4E : =1 =2 =3 O =4 5E ; I ; O 9 S,
2016 8 24 4 233 RS; O 9RS,EORTCQLQ C30 `, 15E 0 T 0 73 X,L 0 α T 0 5 X, N 4R7 89:; [6 7], 7: \ 4 R7 89:;S 1 3 2 ] JK H,-,- :; :; 1 4 abc ) T SPSS17 0ab X I,b;45 x±s, t, P<0 05F^_ abc 2 2 1 H,- EORTCQLQ C30`,O H EORTCQLQ C30`,O ^_`abc (P>0 05) ( 2);,-Q R HT 2 [ S X ^ _ abc ( P<0 05), I O ^_ `abc ( P>0 05)( 3) 2 2 H,- ],- H ] ^_`abc ( P>0 05) ( 4);,- H ^_ abc ( P<0 01)( 5) 3 " 3 1 2 2 7 S,,- 2347 S,- &, 23 23, 2 R8 &, 4& U 7! 2 H,- EORTCQLQ C30`,O (x±s, ) Table2 ComparisonofEORTCQLQ C30scoresintwogroupsbeforeradiotherapy(x±s,scores) HJ D [ GH (n=50) 62 4±13 1 62 2±10 6 59 8±13 4 62 3± 9 2 63 5± 9 8 32 2±12 3 19 8±10 4 JKH (n=50) 65 6±12 3 63 8±12 5 60 1±14 3 61 9±11 7 64 7±12 0 33 5±11 8 18 1±11 1 t 1 259 0 690 0 108-0 190 0 547 0 539-0 790 P 0 211 0 491 0 914 0 849 0 585 0 590 0 431 HJ 2! "# ( S GH (n=50) 31 2±13 5 41 7±20 3 49 2±11 8 44 0±16 1 46 9±15 1 32 3±14 3 46 7±20 1 77 5±12 0 JKH (n=50) 29 6±14 8 40 2±16 7 48 1±13 5 43 1±17 3 44 2±13 8 31 7±11 5 45 3±23 7 78 2±11 0 t -0 564-0 403-0 433-0 269-0 933-0 231-0 318 0 304 P 0 573 0 687 0 665 0 788 0 353 0 817 0 750 0 000 \:EORTCQLQ C30: 4R6-H1, 89:;Z[;! 3 H,- EORTCQLQ C30`,O (x±s, ) Table3 ComparisonofEORTCQLQ C30scoresintwogroupsafterradiotherapy(x±s,scores) HJ D [ GH (n=50) 63 8±12 4 54 9±12 5 47 2±13 4 54 5±10 8 52 5±13 7 45 8±15 0 29 9±11 3 JKH (n=50) 75 6±13 1 55 6±11 3 46 8±14 2 56 7±11 7 61 9±14 3 36 6±13 2 21 5±10 3 t 4 625 0 293-0 145 0 977 3 356-3 255-3 884 P 0 000 0 769 0 885 0 331 0 001 0 001 0 000 HJ 2! "# ( S GH (n=50) 44 3±17 0 57 2±14 3 51 6±13 6 59 0±15 8 49 8±13 9 38 4±14 6 57 6±22 3 58 2±12 8 JKH (n=50) 34 8±16 1 49 2±15 7 50 3±12 3 50 2±16 2 48 3±14 6 37 5±15 1 56 5±20 6 68 8±13 4 t -2 869-2 663-0 501-2 224-0 526-0 303-0 256 4 045 P 0 005 0 009 0 617 0 016 0 600 0 763 0 798 0 000 \:EORTCQLQ C30: 4R6-H1, 89:;Z[;
234 2016 8 24 4! 4 H,- ] (x±s) Table4 Comparisonofnutritionalindexesoftwogroupsbeforeradiotherapy(x±s) HJ BW (kg) BMI(kg/m 2 ) Hb(g/L) ALB (g/l) PA (mg/l) GH (n=50) 59 2±8 4 21 3±1 5 123 1±4 9 34 7±5 2 196 45±30 23 JKH (n=50) 58 4±7 5 21 1±1 8 121 2±5 7 34 5±5 1 195 41±31 03 t 0 5023 0 6036 1 7874 0 1942 0 1698 P 0 6166 0 5475 0 0770 0 8464 0 8656 \:BW: :;;BMI: :; ;Hb: ;ALB: ;PA:! 5 H,- ] (x±s) Table5 Comparisonofnutrtinalindexesoftwogroupsafterradiotherapy(x±s) HJ BW (kg) BMI(kg/m 2 ) Hb(g/L) ALB (g/l) PA (mg/l) GH (n=50) 54 4±7 3 18 4±2 8 107 3±9 5 29 0±5 3 174 56±36 26 JKH (n=50) 59 3±8 5 21 9±2 1 125 9±8 9 35 1±6 9 213 54±37 47 t 3 0924 7 0711 11 2761 4 9575 5 2861 P 0 0026 0 0001 0 0001 0 0001 0 0001 \:BW: :;;BMI: :; ;Hb: ;ALB: ;PA: : 2F 01 JKH7 0F ;2 2N 5 78 :; ; <8, / / /01F 2N, $I%2,&'&, -2 23 [8] 2 \ K K I 2, -& R 8 2 7, 7, F 3 GF3 ;/01 /01 /, ; ;, 3 7, H ZIJ ` FQPQ, - ; 01,JKH7,- $ 2,7 S 9 GH (P<0 01), :; ]`,7 T 2 [ 9 GH (P<0 05), 9 2 234,-7 S,7 ( #<,-, 7 89:;, OTX )* 3 2 RS 7,-!" [ 2 + RS,$ 2, ' /,-. =>?<8, -7 + I23 RS 23 2347,- O & R, 8 F 46 0% ~78 2% [9] 0H A23 8 F 80 5%, 0H A MN/, -6- JKH$ N# $ %&' ; 0 N, 18 N; ; N, 23 +, I 23 ;7 /,'- 8 ; *< < & ; < 4 N;= F2 6!,& < 3 ; / B F2!; 8 4 5;:;,-. 6 2 9 %7 8 2 34, -7 92NX:2, 2 [ RS [10] I I ; 7 UV8, RS $,JKH RS GH (P<0 05) 3 3 [! [ 7 [ 2,N>( 0VPQ S,- 7,5 R & R, 89:;$ %, 7 [ JKH$, 0 B [11], [, 7 6-<, 2=,$ ^ K,7 [, >, [ 2,6-
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