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胃癌患者的实际5年营养结局

Actual 5-Year Nutritional Outcomes of Patients with Gastric Cancer.

作者信息

Kim Ki Hyun, Park Dong Jin, Park Young Suk, Ahn Sang Hoon, Park Do Joong, Kim Hyung Ho

机构信息

Department of Surgery, Seoul National University Bundang Hospital, Seongnam, Korea.

Department of Surgery, Seoul National University College of Medicine, Seoul, Korea.

出版信息

J Gastric Cancer. 2017 Jun;17(2):99-109. doi: 10.5230/jgc.2017.17.e12. Epub 2017 May 23.

Abstract

PURPOSE

In this study, we aimed to evaluate the rarely reported long-term nutritional results of patients with gastric cancer after curative gastrectomy.

MATERIALS AND METHODS

We retrospectively reviewed the prospectively collected medical records of 658 patients who underwent radical gastrectomy with curative intent for gastric cancer from January 2008 to December 2009 and had no recurrences. All patients were followed for 5 years. Nutritional statuses were assessed using measurements of body weight, serum hemoglobin, total lymphocyte count (TLC), protein, albumin, cholesterol, and nutritional risk index (NRI).

RESULTS

Patients who underwent total gastrectomy had lower body weights, hemoglobin, protein, albumin, and cholesterol levels. TLC and NRI valued after the first postoperative year (P<0.05), and lower hemoglobin and NRI valued during the fifth postoperative year than patients who underwent distal gastrectomy (P<0.05). Patients who received adjuvant chemotherapy after gastrectomy had lower hemoglobin, protein, albumin, and cholesterol levels. TLC and NRI valued during the first postoperative year, than those who underwent gastrectomy only (P<0.05). Regarding post-distal gastrectomy reconstruction, those who underwent Roux-en-Y had lower cholesterol levels than did those who underwent Billroth-I and Billroth-II reconstruction at the first and fifth years after gastrectomy, respectively (P<0.05).

CONCLUSIONS

Patients undergoing total or distal gastrectomy with Roux-en-Y anastomosis or adjuvant chemotherapy after surgery should be monitored carefully for malnutrition during the first postoperative year, and patients undergoing total gastrectomy should be monitored for malnutrition and anemia for 5 years.

摘要

目的

在本研究中,我们旨在评估胃癌患者根治性胃切除术后鲜有报道的长期营养状况。

材料与方法

我们回顾性分析了2008年1月至2009年12月期间接受胃癌根治性切除术且无复发的658例患者的前瞻性收集的病历。所有患者均随访5年。通过测量体重、血清血红蛋白、总淋巴细胞计数(TLC)、蛋白质、白蛋白、胆固醇和营养风险指数(NRI)来评估营养状况。

结果

接受全胃切除术的患者体重、血红蛋白、蛋白质、白蛋白和胆固醇水平较低。术后第一年TLC和NRI值(P<0.05),且术后第五年血红蛋白和NRI值低于接受远端胃切除术的患者(P<0.05)。胃切除术后接受辅助化疗的患者血红蛋白、蛋白质、白蛋白和胆固醇水平较低。术后第一年TLC和NRI值低于仅接受胃切除术的患者(P<0.05)。关于远端胃切除术后重建,接受Roux-en-Y吻合术的患者在胃切除术后第一年和第五年的胆固醇水平分别低于接受毕Ⅰ式和毕Ⅱ式重建的患者(P<0.05)。

结论

接受全胃切除术或远端胃切除术加Roux-en-Y吻合术或术后辅助化疗的患者在术后第一年应密切监测营养不良情况,接受全胃切除术的患者应监测5年的营养不良和贫血情况。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a7ca/5489549/919b070d2e9b/jgc-17-99-g001.jpg

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Actual 5-Year Nutritional Outcomes of Patients with Gastric Cancer.胃癌患者的实际5年营养结局
J Gastric Cancer. 2017 Jun;17(2):99-109. doi: 10.5230/jgc.2017.17.e12. Epub 2017 May 23.

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