Comprehensive nursing care for advanced digestive malignancy patients during chemotherapy based on probiotic intervention: a randomized controlled study on improvement of gastrointestinal function and prevention of complications

基于益生菌干预的晚期消化系统恶性肿瘤化疗患者综合护理:一项关于改善胃肠功能和预防并发症的随机对照研究

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Abstract

OBJECTIVE: This study aims to investigate the effects of a comprehensive nursing protocol combined with a probiotic intervention on improving gastrointestinal function, reducing non-infectious complications, and enhancing the quality of life in patients with advanced digestive malignancies undergoing chemotherapy, thereby providing evidence-based support for chemotherapy nursing care. METHODS: A total of 300 advanced digestive malignancy patients undergoing chemotherapy at Our Oncology Specialty Hospital from January 2021 to December 2024 were randomly divided into a control group (150 patients) and an observation group (150 patients) using a random number table. The control group received conventional chemotherapy nursing care, while the observation group received a combined probiotic intervention along with comprehensive nursing care. Baseline data, gastrointestinal function scores (bloating, diarrhea, constipation, nausea/vomiting), nutritional status indicators (serum albumin, prealbumin, BMI), and quality of life scores (EORTC QOLQ-C30) were recorded before and after 2, 4, and 8 weeks of intervention. Non-infectious complications and nursing satisfaction were also evaluated. The dynamic effects of the intervention were analyzed using Generalized Estimation Equations (GEE). RESULTS: No significant differences were observed between the groups at baseline (P>0.05). However, after 2, 4, and 8 weeks of intervention, the observation group exhibited significantly improved gastrointestinal function, with lower scores across all dimensions compared to the control group (P<0.05). At week 8, the total gastrointestinal function score in the observation group (1.57 ± 0.58) was significantly lower than the control group (3.74 ± 1.05) (t=22.156, P = 0.000). The observation group also showed significantly higher nutritional indicators: serum albumin (41.53 ± 2.96 vs. 36.18 ± 3.42), prealbumin (276.41 ± 17.53 vs. 218.65 ± 20.37), and BMI (23.58 ± 2.86 vs. 22.37 ± 3.21) (P<0.01). Additionally, the observation group had higher quality of life scores and lower complication rates (P<0.05), with increased nursing satisfaction. GEE analysis confirmed that the observation group showed greater improvements in all measured indicators over time compared to the control group (P<0.01). CONCLUSION: The comprehensive nursing protocol with probiotic intervention significantly improves gastrointestinal function, enhances nutritional status, reduces non-infectious complications, and boosts the quality of life in chemotherapy patients with advanced digestive malignancy. This intervention demonstrates substantial clinical benefits and therapeutic value.

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