Department of Clinical Nursing, Faculty of Health Sciences, Jagiellonian University, Medical College, ul. Kopernika 25, 31-501 Krakow, Poland.
Department of General, Oncological and Gastroenterological Surgery, Jagiellonian University, Medical College, ul.Kopernika 40, 31-00 Krakow, Poland.
Int J Environ Res Public Health. 2019 Jan 15;16(2):226. doi: 10.3390/ijerph16020226.
Surgical trauma can result in immobilization of biological material, degradation of muscle proteins, synthesis of acute-phase proteins in the liver, occurrence of catabolism phase and anabolism simultaneously, and as a consequence weight loss and nutritional deficiencies. The aim of this study was to assess the nutritional status of patients with ischemic heart disease subjected to coronary artery bypass surgery and physical activity and postoperative complications. The analysis among 96 men included total number of lymphocytes (TNL), body mass index (BMI), case history of a patient and results of laboratory tests. The activities of daily living (ADL) and the mini nutritional assessment (MNA) questionnaires were used. According to TNL, before the procedure malnutrition occurred in 46% of patients. BMI revealed overweight in 62.5% and obesity in 26.0%. After the surgery, no changes were observed. According to MNA, 59% of patients before the surgery were at risk of malnutrition. After the operation, the number of people at risk of malnutrition increased by 50% ( < 0.0001). The correlation was noted between BMI and patients' efficiency in the fifth day after the surgery ( = 0.0031). Complications after the surgery occurred in 35.4% of patients. After the surgery, the risk of malnutrition increased, decreased activity and complications occurred more frequently in people with underweight, obesity, and overweight than in people with normal BMI.
手术创伤可导致生物物质固定、肌肉蛋白降解、肝脏中急性期蛋白合成、同时发生分解代谢和合成代谢，从而导致体重减轻和营养不足。本研究旨在评估接受冠状动脉旁路手术的缺血性心脏病患者的营养状况以及体力活动和术后并发症。对 96 名男性进行了分析，包括总淋巴细胞数（TNL）、体重指数（BMI）、患者病史和实验室检查结果。使用了日常生活活动（ADL）和微型营养评估（MNA）问卷。根据 TNL，在手术前，46%的患者存在营养不良。BMI 显示超重占 62.5%，肥胖占 26.0%。手术后没有变化。根据 MNA，术前 59%的患者有营养不良的风险。手术后，有营养不良风险的人数增加了 50%（<0.0001）。术后第 5 天，BMI 与患者的效率呈正相关（=0.0031）。术后并发症发生在 35.4%的患者中。手术后，体重不足、肥胖和超重的人发生营养不良的风险增加、活动减少且并发症更频繁，而 BMI 正常的人则没有。
