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胃切除术后使用具有营养相关性的生活质量量表:提供个性化治疗的一项挑战

Using Quality of Life Scales with Nutritional Relevance after Gastrectomy: a Challenge for Providing Personalized Treatment.

作者信息

Lee Seung Soo, Yu Wansik, Chung Ho Young, Kwon Oh Kyoung, Lee Won Kee

机构信息

Department of Surgery, Kyungpook National University Hospital, Kyungpook National University School of Medicine, Daegu, Korea.

Gastric Cancer Center, Kyungpook National University Chilgok Hospital, Kyungpook National University School of Medicine, Daegu, Korea.

出版信息

J Gastric Cancer. 2017 Dec;17(4):342-353. doi: 10.5230/jgc.2017.17.e39. Epub 2017 Dec 18.

Abstract

PURPOSE

This study evaluated the changes in nutritional status based on quality of life (QoL) item-level analysis to determine whether individual QoL responses might facilitate personal clinical impact.

MATERIALS AND METHODS

This study retrospectively evaluated QoL data obtained by the European Organisation for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire-Core 30 (QLQ-C30) and Quality of Life Questionnaire-Stomach (QLQ-STO22) as well as metabolic-nutritional data obtained by bioelectrical impedance analysis and blood tests. Patients were assessed preoperatively and at the 5-year follow-up. QoL was analyzed at the level of the constituent items. The patients were categorized into vulnerable and non-vulnerable QoL groups for each scale based on their responses to the QoL items and changes in the metabolic-nutritional indices were compared.

RESULTS

Multiple shortcomings in the metabolic-nutritional indices were observed in the vulnerable groups for nausea/vomiting (waist-hip ratio, degree of obesity), dyspnea (hemoglobin, iron), constipation (body fat mass, percent body fat), dysphagia (body fat mass, percent body fat), reflux (body weight, hemoglobin), dry mouth (percent body fat, waist-hip ratio), and taste (body weight, total body water, soft lean mass, body fat mass). The shortcomings in a single index were observed in the vulnerable groups for emotional functioning and pain (EORTC QLQ-C30) and for eating restrictions (EORTC QLQ-STO22).

CONCLUSIONS

Long-term postoperative QoL deterioration in emotional functioning, nausea/vomiting, pain, dyspnea, constipation, dysphagia, reflux, eating restrictions, dry mouth, and taste were associated with nutritional shortcomings. QoL item-level analysis, instead of scale-level analysis, may help to facilitate personalized treatment for individual QoL respondents.

摘要

目的

本研究基于生活质量(QoL)项目层面分析评估营养状况的变化,以确定个体QoL反应是否有助于产生个人临床影响。

材料与方法

本研究回顾性评估了欧洲癌症研究与治疗组织(EORTC)生活质量问卷核心30(QLQ-C30)和生活质量问卷-胃癌(QLQ-STO22)获得的QoL数据,以及生物电阻抗分析和血液检测获得的代谢营养数据。在术前和5年随访时对患者进行评估。在构成项目层面分析QoL。根据患者对QoL项目的反应,将患者分为每个量表的脆弱和非脆弱QoL组,并比较代谢营养指标的变化。

结果

在恶心/呕吐(腰臀比、肥胖程度)、呼吸困难(血红蛋白、铁)、便秘(体脂量、体脂百分比)、吞咽困难(体脂量、体脂百分比)、反流(体重、血红蛋白)、口干(体脂百分比、腰臀比)和味觉(体重、总体水、软瘦体重、体脂量)的脆弱组中观察到代谢营养指标存在多个缺陷。在情绪功能和疼痛(EORTC QLQ-C30)以及饮食限制(EORTC QLQ-STO22)的脆弱组中观察到单一指标存在缺陷。

结论

术后长期情绪功能、恶心/呕吐、疼痛、呼吸困难、便秘、吞咽困难、反流、饮食限制、口干和味觉的QoL恶化与营养缺陷有关。QoL项目层面分析而非量表层面分析可能有助于为个体QoL应答者提供个性化治疗。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/caf4/5746655/ec538e08c2ba/jgc-17-342-g001.jpg

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