乳清蛋白和维生素D联合抗阻运动改善老年食管癌病人肌肉减少症的临床研究

doi:10.3969/j.issn.1005-6483.20250104

摘要/Abstract

摘要： 目的探讨乳清蛋白和维生素D联合抗阻运动改善老年食管癌病人肌肉减少症的临床效果。方法2023年6月～2024年8月于我院接受治疗的食管癌合并肌肉减少症病人76例，根据营养支持方案的不同分为对照组（38例）和观察组（38例），对照组行常规营养支持治疗，观察组行乳清蛋白和维生素D联合抗阻运动治疗。采用主观整体评估量表（PG-SGA）评估两组病人的营养状况，食管癌特异性量表（QLQ-OES18）评估两组病人的生活质量，并比较两组病人血浆白蛋白（ALB）、血红蛋白（Hb）和C-反应蛋白（CRP）的水平，骨骼肌质量指数、握力和步速等骨骼肌相关指标，以及并发症发生率。结果术后3个月，观察组PG-SGA评分为（11.54±2.03）分，低于对照组的（13.11±1.97）分，差异有统计学意义（P＜0.05）。QLQ-OES18量表显示，观察组吞咽功能评分为（67.43±4.89）分，高于对照组的(64.69±4.26)分，差异有统计学意义（P＜0.05）；观察组进食不适、疼痛和反流评分分别为（56.47±4.69）分、（57.28±5.18）分和（54.94±4.87），低于对照组的（59.51±4.75）分、（60.44±5.05）分和（57.29±5.03）分，差异有统计学意义（P＜0.05）。观察组ALB和Hb分别为（42.26±2.99）g/L和（127.53±10.11）g/L，高于对照组的（34.09±4.61）g/L和（112.81±15.87）g/L，差异有统计学意义（P＜0.05）；观察组CRP为（7.67±2.93）mg/L，低于对照组的（12.78±3.14）mg/L，差异有统计学意义（P＜0.05）。观察组骨骼肌质量指数、握力和步速分别为（6.35±0.92）kg/m₂、（24.85±2.91）kg和（0.96±0.09）m/s，均高于对照组的（5.78±0.77）kg/m₂、（22.88±2.58）kg和（0.87±0.08）m/s，差异有统计学意义（P＜0.05）。两组病人肺部感染、切口感染、吻合口瘘等并发症总发生率比较，差异无统计学意义（P＞0.05）。结论乳清蛋白和维生素D联合抗阻运动方案在改善老年食管癌合并肌肉减少症病人的营养状况、生活质量、骨骼肌功能和生化指标方面具有显著优势。

关键词: 乳清蛋白, 维生素D, 抗阻运动, 食管癌, 肌肉减少症

Abstract: Objective To explore the clinical effect of whey protein and vitamin D combined with anti-resistance exercise in improving sarcopenia in elderly patients with esophageal cancer.Methods Retrospective analysis of clinical data from 76 patients with esophageal cancer and sarcopenia treated at Yancheng Third People's Hospital between June 2023 and August 2024 was conducted.The patients were divided into a control group (38 cases) and an observation group (38 cases) based on different nutritional support regimens.The control group received conventional nutritional support,while the observation group was subjected to a combined intervention of whey protein,vitamin D,and resistance exercise.The nutritional status of patients in the two groups was assessed using the patient Subjective Global Assessment Scale (PG-SGA),the quality of life of patients in the two groups was assessed using the esophageal cancer Specific Scale (QLQ-OES18),and the levels of serum albumen(ALB),hemoglobin(Hb) and C-reactive protein(CRP),skeletal muscle mass index,grip strength and walking speed were compared between the two groups.And complication rates in both groups.Results Three month after operation,the PG-SGA score of the observation group was 11.54±2.03,which was significantly lower than that of the control group （13.11±1.97）(P<0.05).The QLQ-OES18 scale showed that the scores of swallowing function in the observation group (67.43±4.89) were significantly higher than those in the control group(64.69±4.26)(P<0.05),while the scores of eating discomfort,pain and reflux (56.47±4.69,57.28±5.18 and 54.94±4.87) were significantly lower than those in the control group（59.51±4.75,60.44±5.05,57.29±5.03） (P<0.05).In addition,the plasma ALB and Hb of the observation group were （42.26±2.99）g/L and（127.53±10.11）g/L,respectively,which were significantly higher than those of the control group[（34.09±4.61）g/L and（112.81±15.87）g/L] (P<0.05),and the CRP was （7.67±2.93）mg/L,which was significantly lower than that of the control group[（12.78±3.14）mg/L] (P<0.05).The skeletal muscle mass index,grip strength and walking speed of observation group were（6.35±0.92）kg/m

Key words: whey protein, vitamin D, resistance movement, esophageal cancer, sarcopenia

袁甜甜, 李青荷, 吴翠干, 袁丽娟, 万淑华, 徐正君. 乳清蛋白和维生素D联合抗阻运动改善老年食管癌病人肌肉减少症的临床研究[J]. 临床外科杂志, 2026, 34(1): 46-49.

YUAN Tiantian, LI Qinghe, WU Cuigan, YUAN Lijuan, WAN Shuhua, XU Zhengjun. Clinical study of Whey protein and vitamin D combined anti-resistance exercise to improvesarcopenia in elderly patients with esophageal cancer[J]. JOURNAL OF CLINICAL SURGERY, 2026, 34(1): 46-49.

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