量化式目标锻炼联合全程精细化营养管理在血液病化疗患者中的应用效果

朱丽; 唐海龙; 胡蕾; 赵引丽; 郭丝锦

doi:10.16766/j.cnki.issn.1674-4152.003235

量化式目标锻炼联合全程精细化营养管理在血液病化疗患者中的应用效果

doi: 10.16766/j.cnki.issn.1674-4152.003235

1.
空军军医大学第一附属医院血液肿瘤科，陕西西安 710032
2.
空军军医大学第一附属医院甲乳血管外科

基金项目:

国家自然科学基金项目 82100218

详细信息

通讯作者:
郭丝锦，E-mail：nabiboymo@163.com

中图分类号: R55 R453 R459.3
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- 文章访问数: 171
- HTML全文浏览量: 79
- PDF下载量: 11
- 被引次数: 0
出版历程
- 收稿日期: 2022-11-17
- 网络出版日期: 2024-01-13

Application of quantitative goal exercise combined with whole process refined nutrition management in patients with hematological disease chemotherapy

1.
Department of Hematology and Oncology, First Affiliated Hospital of Air Force Military Medical University, Xi' an, Shaanxi 710032, China

摘要

摘要: 目的探讨量化式目标锻炼(QGE)联合全程精细化营养管理(WP-RNM)对血液病化疗患者临床效果的影响，为提高血液病患者化疗后康复管理质量提供依据。方法选取空军军医大学第一附属医院2019年2月—2021年6月收治的血液病化疗患者126例，采用随机数表法分为观察组和对照组各63例。对照组采用常规干预，观察组在常规干预的基础上加用QGE联合WP-RNM干预方案。比较2组干预前后的营养状况、免疫功能及生活质量变化。结果观察组干预后血红蛋白(Hb)、血浆前白蛋白(PAB)、白蛋白(ALB)、转铁蛋白(TRF)均明显高于对照组(均P＜0.001)，主观整体营养状况评估量表(PG-SGA)评分明显低于对照组[(1.92±0.72)分vs.(4.26±0.81)分，t=17.138，P＜0.01]；观察组干预后肿瘤患者生活质量自评量表-30(QLQ-C30)各评分均明显低于对照组(均P＜0.001)；观察组干预后血清IgG抗体(IgG)、IgA抗体(IgA)、IgM抗体(IgM)、CD3⁺T细胞百分比、CD4⁺T细胞百分比均明显高于对照组(t=28.857、6.683、9.191、20.013、12.798，均P＜0.01)。结论 QGE联合WP-RNM能有效提高血液病化疗患者的营养摄入量和免疫功能，改善患者的生活质量。
- 血液病 /
- 化疗 /
- 量化式目标锻炼 /
- 全程精细化营养管理
Abstract: Objective To explore the effect of quantitative targeted exercise (QGE) combined with whole process refined nutrition management (WP-RNM) on the clinical results of patients with hematologic diseases undergoing chemotherapy, and to provide evidence for improving the quality of rehabilitation management of patients with hematologic diseases after chemotherapy. Methods A total of 126 patients with hematologic diseases treated with chemotherapy in First Affiliated Hospital of Air Force Military Medical University from February 2019 to June 2021 were selected and randomly divided into observation group and control group with 63 patients in each group by random number table sampling method. The control group was treated with routine intervention, and the observation group was treated with QGE combined WP-RNM intervention program on the basis of routine intervention. The nutritional status, immune function and life quality of the two groups were compared before and after intervention. Result After intervention, the scores of hemoglobin (Hb), plasma prealbumin (PAB), albumin (Alb), transferrin (TRF) and scored patient-generated subjective global assessment(PG-SGA) in the observation group were significantly higher than those in the control group (all P<0.001). The PG-SGA score was significantly lower than that of the control group [(1.92±0.72) points vs. (4.26±0.81) points, t=17.138, P<0.01]. After intervention, the scores of quality of life questionnaire-C30 (QLQ-C30) in the observation group were significantly lower than those in the control group (all P<0.001). After intervention, serum IgG antibody (IgG), IgA antibody (IgA), IgM antibody (IgM), percentage of CD3⁺T cells and CD4⁺T cells in the observation group were significantly higher than those in the control group (t-values: 28.857, 6.683, 9.191, 20.013 and 12.798, respectively, all P<0.01). Conclusion QGE combined with WP-RNM can effectively improve the nutritional intake and immune function of patients with hematological diseases and improve the quality of life of patients.
- Blood disease /
- Chemotherapy /
- Quantitative goal exercise combined /
- Whole process refined nutrition management

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表 1 2组血液病化疗患者临床资料比较

Table 1. Comparison of clinical data between two groups of chemotherapy patients with hematologic diseases

组别	例数	性别 (男性/女性，例)	年龄(x±s，岁)	疾病类型(例)
组别	例数	性别 (男性/女性，例)	年龄(x±s，岁)	白血病	淋巴瘤	骨髓异常综合征
观察组	63	35/28	51.65±2.71	28	21	14
对照组	63	37/26	51.78±2.79	29	24	10
统计量		0.130^a	0.265^b	0.884^a
P值		0.719	0.791	0.643
注：^a为χ²值，^b为t值。

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表 2 2组血液病化疗患者干预前后营养状况比较(x±s)

Table 2. Comparison of nutritional status between two groups of chemotherapy patients with hematologic diseases before and after intervention (x±s)

组别	例数	Hb(g/L)		PAB(g/L)		ALB(g/L)		TRF(mg/dL)		PG-SGA评分(分)
组别	例数	干预前	干预后	干预前	干预后	干预前	干预后	干预前	干预后	干预前	干预后
观察组	63	102.21±9.72	142.12±11.16^a	127.68±9.65	295.61±13.35^a	26.72±2.79	36.63±2.89^a	152.81±12.73	268.81±14.95^a	8.73±0.85	1.92±0.72^a
对照组	63	101.87±8.92	115.62±11.23^a	128.82±8.93	232.52±12.58^a	26.87±2.85	31.75±2.93^a	149.95±12.71	215.69±13.75^a	8.83±0.26	4.26±0.81^a
t值		0.205	13.285	0.688	27.299	0.299	9.412	1.262	20.758	0.893	17.138
P值		0.838	＜0.001	0.493	＜0.001	0.765	＜0.001	0.209	＜0.001	0.375	＜0.001
注：与同组干预前比较，^aP＜0.05。

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表 3 2组血液病化疗患者干预前后QLQ-C30各项目评分比较(x±s，分)

Table 3. Comparison of QLQ-C30 scores between two groups of chemotherapy patients with hematologic diseases before and after intervention (x±s, points)

组别	例数	食欲质量		睡眠质量		日常生活质量		精神质量		家庭理解与配合程度
组别	例数	干预前	干预后	干预前	干预后	干预前	干预后	干预前	干预后	干预前	干预后
观察组	63	4.31±0.25	1.25±0.15^a	4.33±0.52	1.42±0.36^a	4.11±0.72	1.35±0.62^a	4.28±0.69	1.35±0.27^a	4.26±0.62	1.27±0.31^a
对照组	63	4.33±0.18	2.76±0.16^a	4.35±0.65	2.62±0.58^a	4.15±0.78	3.12±0.85^a	4.24±0.76	3.13±0.26^a	4.32±0.67	3.13±0.16^a
t值		0.515	54.648	0.191	13.953	0.299	13.353	0.309	37.692	0.522	42.319
P值		0.608	＜0.001	0.849	＜0.001	0.765	＜0.001	0.758	＜0.001	0.603	＜0.001
注：与同组干预前比较，^aP＜0.001。

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表 4 2组血液病化疗患者干预前后免疫指标比较(x±s)

Table 4. Comparison of immune indexes between two groups of chemotherapy patients with hematologic diseases before and after intervention (x±s)

组别	例数	IgG(g/L)		IgA(g/L)		IgM(g/L)		CD3⁺(%)		CD4⁺(%)
组别	例数	干预前	干预后	干预前	干预后	干预前	干预后	干预前	干预后	干预前	干预后
观察组	63	8.72±0.13	8.68±0.18	3.19±0.65	3.15±0.72	1.65±0.25	1.59±0.52	56.69±2.78	56.12±2.95	34.71±2.58	34.27±2.82
对照组	63	8.69±0.17	7.56±0.25^a	3.16±0.73	2.35±0.62^a	1.63±0.31	0.96±0.16^a	56.13±0.75	45.83±2.82^a	34.97±2.84	27.69±2.95^a
t值		1.113	28.857	0.244	6.683	0.399	9.191	1.544	20.013	0.538	12.798
P值		0.268	＜0.001	0.808	＜0.001	0.691	＜0.001	0.127	＜0.001	0.592	＜0.001
注：与同组干预前比较，^aP＜0.001。

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