Brandmair W, Lehr L, Siewert J R
Chirurgische Klinik und Poliklinik, Technischen Universität, Klinikum rechts der Isar, München.
Langenbecks Arch Chir. 1989;374(1):25-31. doi: 10.1007/BF01261932.
In a prospective study including 60 patients with esophageal carcinoma the nutritional status was evaluated by means of anthropometric, biochemical and immunological data. As a first measure of malnutrition the diminuation of each single parameter was estimated in a 10%-scale, according to this a linear rising number of points given and the sum for all 11 parameters expressed as a score (Gofferje and Fekl). Second the nutritional status was judged by the prognostic nutritional index (Buzby and Mullen). Both score and index were correlated with serious postoperative complications (wound infection, anastomotic leakage, sepsis, organ failure, death). The results show that it was not possible to assess the risk of esophagectomy preoperatively on the ground of nutritional parameters solely. The reason could be that the nutritional status was rather normal in most cases and its risk burden therefore low. In conclusion performing preoperative nutritional therapy routinely seems not to be justified.
在一项纳入60例食管癌患者的前瞻性研究中,通过人体测量学、生化和免疫学数据对营养状况进行了评估。作为营养不良的首要衡量指标,根据10分制评估每个参数的减少情况,据此给出线性增加的分数,并将所有11个参数的总和表示为一个评分(戈费尔热和费克尔)。其次,通过预后营养指数(布兹比和马伦)来判断营养状况。评分和指数均与严重术后并发症(伤口感染、吻合口漏、败血症、器官衰竭、死亡)相关。结果表明,仅根据营养参数无法在术前评估食管切除术的风险。原因可能是大多数情况下营养状况相当正常,因此其风险负担较低。总之,常规进行术前营养治疗似乎没有依据。