Seo Kyung Won, Yoon Ki Young
Department of Surgery, Kosin University College of Medicine, 262 Gamcheon-ro, Seo-gu, Busan 602-702, Korea.
Korean J Gastroenterol. 2013 Apr;61(4):186-90. doi: 10.4166/kjg.2013.61.4.186.
Weight loss and malnutrition are common in cancer patients. Although weight loss is predominantly due to loss of fat mass, the morbidity risk is given by the decrease in muscle mass. The assessment of nutritional status is essential for a diagnosis of nutritional compromise and required for the multidisciplinary approach. Subjective global assessment (SGA) is made by the patients nutritional symptoms and weight loss. The objective assessment, a significant weight loss (>10%) for 6 months is considered an indicator of nutritional deficiency. The mean body index, body fat mass and body protein mass are decreased as cancer stage increases. The biochemical data of albumin, cholesterol, triglyceride, Zn, transferrin, total lymphocyte count are decreased in advanced cancer stage. Daily energy intake, cabohyderate and Vit B1 intake is decreased according to cancer stage. The patients are divided into three groups according to SGA. The three groups showed a significant difference in body weight, 1 month weight loss%, 6 month weight loss%, body mass index, mid arm circumference, albumin, energy intake, as well as carbohyderate intake protein and energy malnutrition. Nutritional assessment is of great importance because undernutrition has been shown to be associated with increase in stomach cancer associated morbidity and mortality. The authors concluded that nutritional assessment should be done in cancer patients preoperatively, and with adequate nutritional support, the morbidity and mortality would be decreased.
体重减轻和营养不良在癌症患者中很常见。虽然体重减轻主要是由于脂肪量减少,但发病风险是由肌肉量减少引起的。营养状况评估对于诊断营养状况不佳至关重要,并且是多学科方法所必需的。主观全面评定(SGA)是根据患者的营养症状和体重减轻情况进行的。客观评估方面,6个月内体重显著减轻(>10%)被视为营养缺乏的指标。随着癌症分期增加,平均身体指数、体脂肪量和身体蛋白量会降低。在癌症晚期,白蛋白、胆固醇、甘油三酯、锌、转铁蛋白、总淋巴细胞计数的生化数据会降低。根据癌症分期,每日能量摄入、碳水化合物和维生素B1摄入量会减少。根据SGA将患者分为三组。这三组在体重、1个月体重减轻百分比、6个月体重减轻百分比、身体质量指数、上臂中部周长、白蛋白、能量摄入以及碳水化合物摄入蛋白质和能量营养不良方面存在显著差异。营养评估非常重要,因为已表明营养不良与胃癌相关的发病率和死亡率增加有关。作者得出结论,应在癌症患者术前进行营养评估,并且通过适当的营养支持,发病率和死亡率将会降低。