胃癌根治术后化疗期间营养状况与生活质量相关性 研究

Correlation between nutritional status and quality of life during chemotherapy after radical gastrectomy

目的探讨胃癌根治术后患者辅助化疗期间营养不良发生情况与患者生活质量的相关性。方法采用便利抽样法选取2017年12月至2019年11月于四川省肿瘤医院行胃癌根治性手术后辅助化疗的患者为研究对象,用纵向观察性方法,在患者化疗前期、中期、后期评估其营养不良发生率和生活质量。结果173例患者完成了营养风险筛查及营养评定,随着化疗周期的进展,营养不足发生率逐渐增加,差异具有统计学意义(P<0.05);血液相关营养指标及人体成分测量(125例完成)结果显示各项指标均呈下降趋势,差异具有统计学意义(P<0.05),患者体重的丢失,主要是去脂体重[化疗前(50.18±10.27)kg,化疗中(47.83±9.52)kg,化疗后(44.64±9.31)kg]和蛋白质量[化疗前(10.97±2.11)kg,化疗中(10.56±2.03)kg,化疗后(10.21±1.93)kg]的丢失为主;生活质量评分亦随着化疗周期的进展逐渐降低,差异具有统计学意义(P<0.05)。结论随着化疗周期的进展,胃癌根治术后行辅助化疗的患者,营养风险及营养不足的发生率逐渐增加,患者血液相关营养指标及人体成分测量指标逐渐降低,患者体重丢失以去脂体重丢失为主,患者生活质量评分逐渐降低。

Objective To investigate the correlation between malnutrition and quality of life during adjuvant chemotherapy in patients with radical gastrectomy for gastric cancer.Methods Patients receiving adjuvant chemotherapy after radical gastrectomy in Sichuan Cancer Hospital from December 2017 to November 2019 were selected by convenience sampling method.The incidence of nutritional risk was assessed in the pre-chemotherapy,mid-chemotherapy and post-chemotherapy stages using longitudinal observational methods.The quality of life of the cancer patients was also investigated.Results There were 173 patients completed nutritional risk screening and nutrition assessment with the progress of chemotherapy cycle,and the incidence of nutritional risk also increased gradually,with statistically significant differences.The total PG⁃SGA score of patients gradually increased with the progress of chemotherapy,and the incidence of malnutrition gradually increased,with statistically significant difference.The results of blood related nutrition indexes and human body composition measurement(125 cases completed)showed that all indexes showed a downward trend,and the difference was statistically significant.The loss of body mass of patients was mainly the loss of lipid⁃removing body mass.The quality of life score also decreased with the progression of chemotherapy cycle,and the difference was statistically significant.Conclusion With the progress of the cycles of chemotherapy,adjuvant chemotherapy patients after gastric cancer radical,gradually increased the incidence of nutritional risk and nutritional deficiencies,a patient′s blood related to nutrition and body composition measurement indicators gradually reduce,the patient body quality loss is given priority to with to fat mass loss,gradually reduce the patients quality of life score,suggests we should pay attention to and improve the nutritional status of patients,improve the quality of life of patients.