胃癌患者的营养治疗专家共识

Expert consensus on nutritional treatment for patients with gastric cancer

近年来世界范围内胃癌整体发病率在逐渐下降,但在我国仍为高发肿瘤,胃癌患者一旦发生营养不良,在围手术期因骨骼肌质量和功能下降,术后并发症、院内感染发生率及死亡率升高,住院时间延长,生活质量下降,医疗费用增加;在晚期胃癌患者将会因营养不良导致围放化疗期不良反应发生率增加,治疗耐受性下降,治疗完成度下降,影响疗效和生活质量,最终导致生存期缩短等。摄入不足、体重丢失、抗肿瘤治疗(包括手术、放疗、化疗)是选择营养干预适应证的考虑因素,现阶段针对胃癌患者进行营养支持,首要目标是维持瘦体组织,减少围手术期和围放化疗期并发症的发生,保证胃癌根治术的安全顺利完成,保证放化疗足剂量足疗程完成,最终改善疗效和预后,并从卫生经济学角度实现获益。

In recent years,the incidence rate of gastric cancer has gradually declined in the world,but it is still a high incidence of cancer in China.Once malnutrition occurs in patients with gastric cancer,due to the decline of skeletal muscle quality and function in the perioperative period,the incidence of postoperative complications,hospital infection and mortality have increased,the length of hospital stay has been prolonged,the quality of life has declined,and medical costs have increased;In patients with advanced gastric cancer,malnutrition will lead to an increase in the incidence of adverse reactions,a decline in treatment tolerance and completion,and affect the efficacy and quality of life,also ultimately lead to a shortened survival period.Inadequate intake,weight loss,and anti-tumor treatment(including surgery,radiotherapy,and chemotherapy)are the main factors considered in selecting the indications for nutritional intervention.At this stage,the primary goal of nutritional support for patients with gastric cancer is to maintain lean tissue,reduce the incidence of complications during peri-operation and peri-radiotherapy,ensure the safe and smooth completion of radical surgery for gastric cancer,ensure the completion of full dose and treatment of radiotherapy and chemotherapy,and ultimately improve the efficacy and prognosis,and realize benefits from the perspective of health economics.