Nakamura Yoshihiro, Momoki Chika, Okada Genya, Matsumoto Yoshinari, Yasui Yoko, Habu Daiki, Matsuda Yasunori, Lee Shigeru, Osugi Harushi
Department of Nutritional Medicine, Graduate School of Human Life Science, Osaka City University, 3-3-138 Sugimoto, Sumiyoshi-ku, Osaka 558-8585, Japan.
Nutritional Control Unit, Treatment Technique Section, Treatment Technique Department, Nagoya City University Hospital, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya-city, Aichi 467-8602, Japan.
J Clin Med Res. 2019 Mar;11(3):188-195. doi: 10.14740/jocmr3704. Epub 2019 Feb 13.
We investigated the relationship between the preoperative psychological state and the perioperative nutritional conditions of patients with esophageal cancer.
Seventy-three participants underwent operations for esophageal cancer in our hospital. Depressive state was evaluated using the Self-Rating Depression Scale (SDS). General quality of life (QOL) was assessed using the SF-8™, and the nutritional assessments were evaluated through anthropometric analysis, bioelectrical impedance analysis (BIA) and some biochemical assessments.
In the preoperative stage, patients with higher SDS scores, representing a more depressive state, had low arm circumference, grip strength, serum albumin levels and prognostic nutritional index. Patients with higher SDS scores also had a tendency for a lower physical component summary, representing physical QOL by the Eight-Item Short Form Health Survey (SF-8™). At 3 months after surgery, patients with higher preoperative SDS scores had significantly lower body mass indexes (BMIs) and had a lower tendency of body fat masses. In the univariate and multivariate analyses on the recovery of BMI at 3 months after surgery, preoperative SDS score was the only independent risk factor (odd ratio (OR): 4.07, 95% confidence interval (CI): 1.15 - 14.35) in this study.
Preoperative depressive mood, as evaluated by the SDS, was the sole relevant factor for postoperative body weight recovery of patients with esophageal cancer. Preoperative depressive mood of patients with esophageal cancer might delay recovery from operation-related malnutrition. Some measures against preoperative depressive mood might be necessary for early recovery from postoperative malnutrition in patients with esophageal cancer.
我们研究了食管癌患者术前心理状态与围手术期营养状况之间的关系。
73名参与者在我院接受了食管癌手术。使用自评抑郁量表（SDS）评估抑郁状态。使用SF-8™评估总体生活质量（QOL），并通过人体测量分析、生物电阻抗分析（BIA）和一些生化评估来评估营养状况。
在术前阶段，SDS评分较高（代表更抑郁状态）的患者臂围、握力、血清白蛋白水平和预后营养指数较低。SDS评分较高的患者身体成分总结得分也有较低的趋势，身体成分总结由简短健康调查简表（SF-8™）代表身体QOL。术后3个月，术前SDS评分较高的患者体重指数（BMI）显著较低，身体脂肪量的下降趋势也较低。在对术后3个月BMI恢复情况的单因素和多因素分析中，术前SDS评分是本研究中唯一的独立危险因素（比值比（OR）：4.07，95%置信区间（CI）：1.15 - 14.35）。
通过SDS评估的术前抑郁情绪是食管癌患者术后体重恢复的唯一相关因素。食管癌患者术前的抑郁情绪可能会延迟与手术相关的营养不良的恢复。对于食管癌患者术后营养不良的早期恢复，可能需要采取一些措施来应对术前抑郁情绪。
