阶梯式营养干预配合量化式目标锻炼对老年急性髓系白血病化疗患者营养状态及生活质量的影响

The effect of stepwise nutritional intervention combined with quantitative target exercise onthe nutritional status and quality of life of elderly patients with acute myeloid leukemia undergoing chemotherapy

中文关键词: 老年  急性髓系白血病  化疗耐受性  阶梯式营养干预  量化式目标锻炼  营养状态  生活质量

英文关键词: elderly  acute myeloid leukemia  chemotherapy tolerance  stepwise nutritional intervention  quantitative target exercise  nutritional status  quality of life

中文摘要:

      目的 探究阶梯式营养干预配合量化式目标锻炼对老年急性髓系白血病(AML)化疗患者营养状态及生活质量的影响.方法 选取2019 年5 月—2020 年7 月接受传统营养干预的患者55 例及2020 年8 月—2021 年12 月接受阶梯式营养干预的患者55 例的临床资料进行回顾性分析,按照患者不同营养干预方式分为观察组(n =55)和对照组(n =55).2 组患者均进行低强度常规化疗;此外2 组均接受量化式目标锻炼,对照组患者采取传统营养干预,观察组患者采取阶梯式营养干预;2 组患者均进行干预3 个月.比较2 组患者干预3 个月后治疗效果;观察并比较2 组患者干预前、出院前、干预3 个月后转铁蛋白(TRF)、血清白蛋白(ALB)、患者主观整体评估(PG-SGA)评分、人体质量指数(BMI)、三头肌皮褶厚度、癌症生命质量测定量表(FACT-G)评分、美国东部肿瘤协作组(ECOG)评分、治疗中断次数;比较2 组患者干预期间不良事件发生情况.结果 干预3 个月后,观察组患者治疗总有效率明显高于对照组(81.8%vs 63.6%,P＜0.05).2 组患者出院前及干预3 个月后TRF、ALB水平、BMI、三头肌皮褶厚度、FACT-G各项评分均明显高于同组干预前,且观察组上述指标值均明显高于对照组(P＜0.05).2 组患者出院前BMI差异无统计学意义(P＞0.05).2 组患者出院前及干预3 个月后 PG-SGA、ECOG评分明显低于同组干预前,且观察组PG-SGA、ECOG评分均明显低于对照组(P＜0.05),而2 组患者出院前ECOG评分差异无统计学意义(P＞0.05).干预期间,观察组患者治疗中断次数明显少于对照组(P＜0.05),而2 组总不良反应发生率差异无统计学意义(P＞0.05).结论 阶梯式营养干预配合量化式目标锻炼可有效改善老年AML化疗患者的营养状态,促进患者化疗耐受性及化疗效果的提升,改善患者生活质量,具有一定的临床应用价值.

英文摘要:

      Objective To explore the effect of stepwise nutritional intervention combined with quantitative target exer? cise on the nutritional status and quality of life of elderly patients with acute myeloid leukemia (AML) undergoing chemothera? py. Methods The clinical data of 55 patients who received traditional nutritional intervention from May 2019 to July 2020 and 55 ones who received stepwise nutritional intervention from August 2020 to December 2021 were retrospectively analyzed. They were divided into observation group (n =55) and control group (n =55) according to the different methods of nutritional inter? vention. Both groups received low?intensity conventional chemotherapy and quantitative target exercise. The control group was given traditional nutritional intervention, while the observation group was given stepwise nutritional intervention. Both groups were intervened for 3 months. The therapeutic effect was compared between the two groups after 3 months of intervention. The levels of transferrin (TRF) and serum albumin (ALB), Patient?Generated Subjective Global Assessment (PG?SGA) score, body mass index (BMI), triceps skinfold thickness, Functional Assessment of Cancer Therapy?General (FACT?G) score and Eastern Cooperative Oncology Group (ECOG) score before intervention, before discharge and after 3 months of intervention were observed and compared between two groups. The number of treatment interruptions and occurrence of adverse events dur?ing intervention were compared between both groups. Results After 3 months of intervention, the total effective rate of clini? cal treatment in the observation group (81. 8% ) was significantly higher than that in the control group (63. 6% ) (P <0. 05). Before discharge and after 3 months of intervention, the levels of TRF and ALB, BMI, triceps skinfold thickness and scores of items of FACT?G in both groups were significantly higher than those of the same group before intervention, and above indexes in the observation group were significantly higher than those in the control group (P <0. 05). There was no statistical signifi? cance in BMI between the two groups before discharge (P >0. 05). The scores of PG?SGA and ECOG in both groups before discharge and after 3 months of intervention were significantly lower than those of the same group before intervention, and the scores in the observation group were significantly lower than those in the control group (P <0. 05). There was no significant difference in ECOG score before discharge between both groups (P >0. 05). During intervention, the number of treatment in? terruptions in the observation group was significantly less than that in the control group (P <0. 05), and there was no signifi? cant difference in the total incidence of adverse reactions between both groups (P >0. 05). Conclusion Stepwise nutritional intervention combined with quantitative target exercise can effectively improve the nutritional status of elderly AML patients un? dergoing chemotherapy, promote the improvements of chemotherapy tolerance and effect, and improve the quality of life of pa? tients. It has certain clinical application value.