胰酶制剂对全胃切除术后患者生活质量的影响

The impact of exogenous trypsin supplement on the quality of life of patients after total gastrectomy

目的研究补充外源性胰酶是否可以改善胃癌患者行全胃切除术后的生活质量。方法将106例符合试验要求的患者分为试验组和对照组，每组53例。试验组予口服胰酶胶囊，对照组不用胰酶。每例患者在术后6个月时填写1次EORTCQLQ—C30问卷和Korenaga问卷，并测定粪便脂肪含量。比较两组患者手术后各项评分是否有统计学差异，评价补充外源性胰酶是否可以改善患者的生活质量，同时通过分析粪便脂肪含量来评估其对患者术后脂肪泻的影响。结果术后6个月时86例患者接受评价，通过EORTCQLQ—C30和Korenaga评分系统对患者手术后生活质量的评估和粪便脂肪含量的分析显示，通过补充外源性胰酶可以减少体重丢失，缓解食欲减退、失眠、疲劳、餐后饱胀、恶心、呕吐和腹泻等症状，并且改善肠道对脂肪的耐受性及患者健康状况。结论全胃切除引起胰腺外分泌功能障碍，通过补充外源性胰酶可以改善患者术后的生活质量。

Objective To improve the quality of life in gastric cancer patients after total gastreetomy by exogenous trypsin supplement. Method In this study 106 patients were divided into two groups, with 53 patients in each group, oral pancreatic enzyme capsule was given in comparison without in control group. Patients were asked to fill in EORTC QLQ-C30 questionnaire and Korenaga questionnaire at half a year postoperation, stool sample was collected at the same time for fecal fat assay. Results A total of 86 patients completed this test at postoperation half a year. With a comprehensive assessment of quality of life in patients by the scoring system of EORTC QLQ-C30 and Korenaga and the fecal fat contents measurement. Exogenous trypsin plays a positive role in preventing weight loss, improving emotional function, alleviating loss of appetite, insomnia, fatigue, postprandial fullness, nausea, vomiting and diarrhea, and improving intestinal tolerance to fat and the overall health status of patients. Conclusions Total gastrectomy causes exocrine pancreatic dysfunction, exogenous supplement of the enzyme improves postoperative quality of life in these patients.