空肠置管肠内营养对胃癌患者术后生活质量的影响

Effect of Enteral Nutrition via Jejunostomy Catheter on Quality of Life in Gastric Cancer Patients Who Have Undergone Gastrectomy

目的评估空肠穿刺置管肠内营养对胃癌患者术后生活质量的影响。方法回顾性分析北京协和医院104例胃癌患者的临床病理、营养支持及生活质量资料。所有调查资料均来自前瞻性维持的胃癌数据库。比较空肠置管组与未置管组患者生活质量的差异。结果两组患者基线特征、生活质量评分及术后辅助化疗疗程差异均无统计学意义(P均>0.05)。术后1个月,两组患者的总体健康状况评分(P=0.154)、躯体功能评分(P=0.321)、角色功能评分(P=0.492)和疲劳症状评分(P=0.845)差异均无统计学意义;术后3个月及6个月,与未置管组比较,空肠置管组患者均具有较高的总体健康状况评分(P<0.001,P=0.038)、躯体功能评分(P=0.004,P=0.005)、角色功能评分(P=0.002,P=0.038)及较低的疲劳症状评分(P=0.020,P=0.043)。结论术中空肠置管肠内营养可改善胃癌患者手术生活质量。

Objective To study the effect of enteral nutrition via jejunostomy catheter on the quality of life in gastric cancer patients who have undergone gastreetomy. Methods We retrospectively analyzed clinical data of 104 consecutive patients who had undergone curative resection for gastric cancer in Peking Union Medical College Hospital in 2011. All data were obtained from a prospectively maintained database of gastric cancer. The quality of life was compared between jejunostomy tube group （ n = 49） and tube-free group （ n = 55 ） . Resdts The two groups were matched in gender, age, tumor size, tumor location, histological type, pTNM stage, type of surgery, body mass index （ BMI）, quality of life scales, and cycles of postoperative adjuvant chemo- therapy （all P 〉0. 05） . Also, the global health status （P =0. 154）, physical function score （P =0. 321 ）, role function score （P = 0. 492 ）, and fatigue symptom score （P = 0. 845 ） were not significantly different between these two groups one month after surgery. Three and 6 months after the surgery, patients in the jejunosto- my tube group had significantly higher overall health status scores （ P 〈 0. 001, P = 0. 038）, physical function scores （ P = 0. 004, P = 0. 005 ）, and role function scores （ P = 0. 002, P = 0. 038） and significantly lower fa- tigue symptom scores （ P = 0. 020, P = 0. 043 ） when compared to patients from tube-free group. Conclusion Enteral nutrition via jejunostomy catheter can improve the quality of life of gastric cancer patients who have undergone gastrectomy.