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胃肠道肿瘤患者营养评估的可靠性

Reliability of nutritional assessment in patients with gastrointestinal tumors.

作者信息

Poziomyck Aline Kirjner, Fruchtenicht Ana Valeria Gonçalves, Kabke Georgia Brum, Volkweis Bernardo Silveira, Antoniazzi Jorge Luiz, Moreira Luis Fernando

机构信息

- Programa de Pós-Graduação em Ciências Cirúrgicas, Faculdade de Medicina, Universidade Federal do Rio Grande do Sul (UFRGS). Porto Alegre, RS, Brasil.

- Serviço de Cirurgia do Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, RS, Brasil.

出版信息

Rev Col Bras Cir. 2016 May-Jun;43(3):189-97. doi: 10.1590/0100-69912016003006.

DOI:10.1590/0100-69912016003006
PMID:27556544
Abstract

Patients with gastrointestinal cancer and malnutrition are less likely to tolerate major surgical procedures, radiotherapy or chemotherapy. In general, they display a higher incidence of complications such as infection, dehiscence and sepsis, which increases the length of stay and risk of death, and reduces quality of life. The aim of this review is to discuss the pros and cons of different points of view to assess nutritional risk in patients with gastrointestinal tract (GIT) tumors and their viability, considering the current understanding and screening approaches in the field. A better combination of anthropometric, laboratory and subjective evaluations is needed in patients with GIT cancer, since malnutrition in these patients is usually much more severe than in those patients with tumors at sites other than the GIT. RESUMO Pacientes com neoplasia gastrointestinal e desnutridos são menos propensos a tolerar procedimentos cirúrgicos de grande porte, radioterapia ou quimioterapia. Em geral, apresentam maior incidência de complicações, como infecção, deiscência e sepse, o que aumenta o tempo de internação e o risco de morte, e reduz a qualidade de vida. O objetivo desta revisão é abordar os prós e contras de diferentes pontos de vista que avaliam risco nutricional em pacientes com tumores do Trato Gastrointestinal (TGI) e sua viabilidade, considerando o atual entendimento e abordagens de triagem neste campo. Melhor combinação de avaliações antropométricas, laboratoriais e subjetivas se faz necessária em pacientes com câncer do TGI, uma vez que a desnutrição nestes pacientes costuma ser muito mais grave do que naqueles indivíduos com tumores em outros sítios que não o TGI.

摘要

患有胃肠道癌症和营养不良的患者较难耐受大型外科手术、放疗或化疗。一般来说,他们出现感染、伤口裂开和败血症等并发症的几率更高,这会延长住院时间、增加死亡风险并降低生活质量。本综述的目的是讨论不同观点的利弊,以评估胃肠道(GIT)肿瘤患者的营养风险及其可行性,同时考虑该领域目前的认识和筛查方法。对于GIT癌症患者,需要更好地结合人体测量、实验室和主观评估,因为这些患者的营养不良通常比非GIT部位肿瘤患者严重得多。摘要:患有胃肠道肿瘤和营养不良的患者较难耐受大型外科手术、放疗或化疗。一般来说,他们出现并发症的几率更高,如感染、伤口裂开和败血症,这会延长住院时间、增加死亡风险并降低生活质量。本综述的目的是探讨评估胃肠道(TGI)肿瘤患者营养风险及其可行性的不同观点的利弊,同时考虑该领域目前的认识和筛查方法。对于TGI癌症患者,需要更好地结合人体测量、实验室和主观评估,因为这些患者的营养不良通常比非TGI部位肿瘤患者严重得多。

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