肠内营养对胃癌术后患者短期内营养状况和生活质量的影响

Effect of home enteral nutrition on short-term nutritional status and quality of life in postoperative patients with gastric cancer

目的评估家庭肠内营养对胃癌术后患者短期内营养状况和生活质量的影响。方法该研究是一项单中心的观察性研究。对因胃癌行远端胃/全胃切除的患者,观察记录其出院后12周肠内营养补充剂摄入量并据此分为未达标组和达标组,比较两组患者的体重丢失率等临床指标及生活质量评分。结果120例患者在出院时进行了登记,其中59例完成了观察分析,未达标组38例,达标组21例。所有纳入患者出院12周时体重与出院时体重相比,差异具有统计学意义[(57.9±9.8)kg vs(59.2±11.2)kg,P=0.037];出院12周时血红蛋白含量、淋巴细胞数、血浆总蛋白含量、血浆白蛋白含量均显著高于出院时。生活质量方面,患者出院12周时除便秘、腹泻及恶心和呕吐3项的差异无统计学意义外,其他方面的表现均优于出院时。出院12周时,未达标组的体重丢失率高于达标组[(2.1±10.4)%vs(0.7±6.7)%],但差异无统计学意义(P=0.59)。两组在血液学参数及生活质量方面的差异均无统计学意义。两组中,行全胃切除者体重丢失率的差异具有统计学意义[(5.4±6.5)%vs(-0.3±5.0)%,P=0.031]。结论胃癌术后患者短期内能在营养状况方面从更多的家庭肠内营养中获益,行全胃切除者相比远端胃切除者获益更加显著。

Objective To evaluate the effect of home enteral nutrition on short-term nutritional status and quality of life in postoperative patients with gastric cancer.Methods This study was a single-center observational study.The patients who underwent distal gastrectomy/total gastrectomy for gastric cancer were observed and recorded 12 weeks after discharge and divided into substandard group and standard group.The clinical characteristics such as weight loss rate and quality of life score were compared between the two groups.Results 120 patients were registered at discharge,of whom 59 completed observation and analysis,38 cases in substandard group and 21 cases in standard group.The body weight of all patients at 12 weeks after discharge was significantly higher than that at discharge[(57.9±9.8)kg vs(59.2±11.2)kg,P=0.037],and the hemoglobin content,lymphocyte count,plasma total protein content and plasma albumin content at 12 weeks after discharge were significantly higher than those at discharge.In terms of quality of life,except for constipation,diarrhea,nausea and vomiting,the performance of other items at 12 weeks after discharge was better than that at discharge.At 12 weeks after discharge,the rate of weight loss in the substandard group was significantly higher than that in the standard group[(2.1±10.4)%vs(0.7±6.7)%],but the difference was not statistically significant(P=0.59).There were no significant differences in hematological parameters or quality of life between the two groups.There was significant difference in the rate of weight loss among patients undergoing total gastrectomy between the two groups[(5.4±6.5)%vs(-0.3±5.0)%,P=0.031].Conclusions Postoperative patients with gastric cancer can benefit from home enteral nutrition in terms of nutritional status in the short term.Patients with total gastrectomy gained more benefits than those with distal gastrectomy.