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营养和临床因素对胃癌患者胃切除术后体重和去脂体重丢失的影响。

Nutritional and Clinical Factors Affecting Weight and Fat-Free Mass Loss after Gastrectomy in Patients with Gastric Cancer.

机构信息

Department of Food and Nutrition, Yeonsung University, Anyang 14011, Korea.

Department of Statistics, Chung-Ang University, Seoul 06974, Korea.

出版信息

Nutrients. 2020 Jun 27;12(7):1905. doi: 10.3390/nu12071905.

Abstract

After a gastrectomy, the nutritional status of patients with gastric cancer has great effect on the treatment outcome and patients' quality of life. We investigated the changes in body composition and nutrient intake after gastrectomy in 288 gastric cancer patients. A multiple linear regression analysis was used for each time period to verify the effects of nutritional and clinical factors on weight and fat-free mass loss rates. Gastric cancer patients who underwent a gastrectomy continued to experience weight and fat-free mass loss until three months after surgery and became stagnant at six months. The marginal mean of calorie intake per weight was 24.5, 26.8, and 29.4 kcal at one, three, and six months. The protein intake per kg lean mass was 1.14, 1.14, and 1.16 g at one, three, and six months, respectively. One month after surgery, the rate of weight loss increased significantly in females who received chemotherapy ( < 0.001). At one to three months postoperative, females who had undergone chemotherapy tended to significantly lose weight ( = 0.016). Females with a history of chemotherapy also showed a reduction in fat-free mass for one to three months ( = 0.036). Calorie intake was a significant factor in preventing fat-free mass weight loss at one month after surgery. Chemotherapy was an independent factor affecting the weight and fat-free mass loss rate up to six months after gastrectomy. Careful monitoring of weight and muscle mass changes following active nutritional intervention for sufficient nutrition support could be helpful for patients after gastrectomy.

摘要

胃癌患者胃切除术后的营养状况对治疗效果和患者生活质量有很大影响。我们调查了 288 例胃癌患者胃切除术后体成分和营养素摄入的变化。使用多元线性回归分析每个时间段,以验证营养和临床因素对体重和去脂体重丢失率的影响。行胃切除术的胃癌患者在术后持续经历体重和去脂体重丢失,直至术后三个月,并在术后六个月停滞。术后一个月、三个月和六个月体重每公斤的能量摄入量的边缘均值分别为 24.5、26.8 和 29.4 kcal。术后一个月、三个月和六个月每公斤瘦体重的蛋白质摄入量分别为 1.14、1.14 和 1.16 g。术后一个月,接受化疗的女性体重减轻率显著增加(<0.001)。术后 1 至 3 个月,接受化疗的女性体重明显减轻(=0.016)。有化疗史的女性在术后 1 至 3 个月也出现去脂体重减少(=0.036)。术后一个月的能量摄入是预防去脂体重丢失的重要因素。化疗是影响术后六个月内体重和去脂体重丢失率的独立因素。积极的营养干预和充分的营养支持可以帮助胃切除术后的患者监测体重和肌肉质量的变化。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/871f/7400091/0c0777c88eb7/nutrients-12-01905-g001.jpg

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