胃癌患者术前营养状况对远期预后影响分析

Clinical analysis of the influence of preoperative nutritional status on the long-term prognosis of patients with gastric cancer

目的探讨术前营养状况对胃癌患者远期预后影响,为改善胃癌手术治疗提供参考。方法依据微营养评价法将140例行胃癌根治术治疗患者分为营养正常组(22例)、潜在营养不良组(75例)和营养不良组(43例)。应用SPSS 20.0软件包进行数据处理,年龄、肿瘤直径、躯体功能、心理功能、社会功能、共性症状与副作用、特异模块及总体生活质量等计量资料以(x珋±s)表示,采用t检验;性别、病变部位、TNM分期及分化程度等计数资料采用χ2检验。P<0.05为差异具有统计学意义。结果营养正常组、潜在营养不良组和营养不良组患者肿瘤直径分别为(5.56±1.70)cm、(5.65±1.81)cm、(6.64±1.17)cm,营养不良组显著高于其他2组(t=2.79,3.60,P<0.01);淋巴转移率分别为18.2%、24.0%、51.2%,营养不良组显著高于其他2组(χ2=6.60、9.004,P<0.01);三组患者术后1年生存率分别为86.4%、74.7%、55.8%,2年生存率分别为63.6%、52.0%、27.9%,正常组和潜在营养不良组均显著高于营养不良组,(χ2=8.762、7.786,P<0.05);三组患者生活质量各指标差异均具有统计学意义(F=3.342、3.687、4.892、4.021、3.554、4.336,P<0.05),正常组和潜在营养不良组均显著优于营养不良组,以上差异均有统计学意义。结论术前营养状况对胃癌患者生活质量和生存率具有显著影响,营养不良患者生活质量和生存率均明显降低。

Objective To investigate the effect of preoperative nutritional status on the long-term prognosis of patients with gastric cancer and to improve surgical strategy for the treatrant of gastric cancer. Methods According to mini-nutritional assessment, 140 patients with gastric cancer were divided into three groups ： normal group （22 patients ）, latent malnutrition group （75）, and malnutrition group （43）. SPSS 20. 0 software package was used for data analysis. Measurement data were expressed as mean ± SD and examined by Student＇ s t test. The data included age, tumor dian^ter, physical function, psychological function, social function, common symptoms and side-effects, specific module and overall quality of life. Gender, lesion location, TNM staging and differentiation degree were examined by the Chi-square test. P 〈 0. 05 was considered statistically significant. Results The tumor diameters were （5. 56 ± 1.70） cm, （5.65 ± 1.81） cm and （6. 64 ±1.17） cm in the normal group, latent malnutrition group and malnutrition group respectively, and they were significantly larger in the malnutrition group than in the other two groups （t =2. 79,3. 60, P 〈0. 01 ）. The incidence of lymph node metastasis was 18.2%, 24.0%, and 51.2% in the normal group, latent Irkalnutrition group, and malnutrition group respectively and it was significantly higher in the malnutrition group than in the other two groups X2 =6. 60, 9. 004, P 〈0.01 ）. The 1-year-survival rate was 86.4%, 74.7% , 55.8%, and the 2-year-survival rate was 63.6%, 52.0% and 27.9% in the normal group, latent malnutrition group, and malnutrition group respectively. The survival rate was significantly lower in the malnutrition group than in the other two groups （X2 =8. 762, 7. 786, P 〈0.05）. There was a significant difference in life quality between the three groups （F = 3. 342, 3. 687, 4. 892, 4. 021, 3.554, 4. 336 respectively, P 〈 0. 05 ）, and it was significantly worse in the malnutrition group than in the other two groups. Conclusions Preoperative nutritional status could influence both quality of life and survival of patients with gastric cancer, and the quality of life and survival rate of patients with malnutrition might be worse.