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越南食管癌患者的营养状况与喂养方案——一项研究

Nutritional Status and Feeding Regimen of Patients with Esophagus Cancer-A Study from Vietnam.

作者信息

Pham Van Binh, Nguyen Thi Thanh Hoa, Le Thi Huong, Nguyen Le Tuan Anh, Dang Thi Thu Hang, Dang Viet Dung

机构信息

Abdominal Surgery Department 1 and Robotic Surgery Center, Vietnam National Cancer Hospital, Hanoi 12511, Vietnam.

Clinical Nutrition Center, Vietnam National Cancer Hospital, Hanoi 12511, Vietnam.

出版信息

Healthcare (Basel). 2021 Mar 6;9(3):289. doi: 10.3390/healthcare9030289.

Abstract

BACKGROUND

Esophagus cancer patients are at high risk of malnutrition. This study was performed to assess the nutritional status and dietary intake of newly diagnosed esophageal cancer patients in Vietnam National Cancer Hospital (NCH).

METHODS

A cross-sectional study was conducted on 206 early esophageal cancer inpatients after gastrostomy from September 2017 to June 2018. The chi-squared test, Fisher exact test, and Mann-Whitney test were performed. The software of the Vietnam National Institute of Nutrition was used to evaluate the dietary intake of patients.

RESULTS

All the participants were male with a mean age of 57.1 ± 8.5 years. Overall, 87.4% of patients had dysphagia. Furthermore, 82.5% and 90.8% of patients reported weight loss one and six months pre-diagnosis, respectively. Moreover, 52.9% of patients suffered from mild/moderate malnutrition and 29.6% of patients had severe malnutrition according to the Patient-Generated Subjective Global Assessment (PG-SGA). The body mass index (BMI) and mid upper arm circumference (MUAC) measurement revealed 47.6% and 50% of undernourished patients, respectively. The proportions of patients having malnutrition were 10.7%, 55.8%, and 27.2% according to albumin, prealbumin, and total lymphocyte counts, respectively. The means of energy, protein, lipid, and carbohydrate in the patients' 24 h preoperative diets were 973.6 ± 443.0 kcal/day, 42.4 ± 21.6 g/day, 31.0 ± 15.5 g/day, and 130.0 ± 64.5 g/day. The total energy, total protein, animal protein, total lipid, and plant lipid in the dietary intake of patients were strongly correlated with age, economic classification, and PG-SGA (each < 0.05). The total energy intake increased day by day, with the average energy intake of 1343.9 ± 521.3 kcal on the seventh day. Energy and protein response rates increased day by day and were highest at 7 days post-operation at 18.0% and 19.4%.

CONCLUSION

Malnutrition and insufficient intake are noteworthy in esophageal cancer patients. The PG-SGA is strongly correlated with the dietary intake of patients. The results from this study will help medical staff to prevent malnutrition and improve the nutritional status of esophageal cancer inpatients. Furthermore, public awareness should be raised on recognizing weight loss as an early symptom of esophageal cancer and the utilization of preoperative assessment tools for nutritional assessment and malnutrition management.

摘要

背景

食管癌患者存在营养不良的高风险。本研究旨在评估越南国家癌症医院(NCH)新诊断的食管癌患者的营养状况和饮食摄入情况。

方法

对2017年9月至2018年6月期间206例接受胃造口术的早期食管癌住院患者进行了一项横断面研究。进行了卡方检验、Fisher精确检验和Mann-Whitney检验。使用越南国家营养研究所的软件评估患者的饮食摄入情况。

结果

所有参与者均为男性,平均年龄为57.1±8.5岁。总体而言,87.4%的患者有吞咽困难。此外,分别有82.5%和90.8%的患者报告在诊断前1个月和6个月体重减轻。此外,根据患者主观全面评定法(PG-SGA),52.9%的患者患有轻度/中度营养不良,29.6%的患者患有重度营养不良。体重指数(BMI)和上臂中部周长(MUAC)测量显示,分别有47.6%和50%的患者营养不良。根据白蛋白、前白蛋白和总淋巴细胞计数计算,营养不良患者的比例分别为10.7%、55.8%和27.2%。患者术前24小时饮食中的能量、蛋白质、脂质和碳水化合物的均值分别为973.6±443.0千卡/天、42.4±21.6克/天、31.0±15.5克/天和130.0±64.5克/天。患者饮食摄入中的总能量、总蛋白质、动物蛋白、总脂质和植物脂质与年龄、经济分类和PG-SGA均密切相关(均P<0.05)。总能量摄入量逐日增加,术后第7天的平均能量摄入量为1343.9±521.3千卡。能量和蛋白质反应率逐日增加,术后7天最高,分别为18.0%和19.4%。

结论

食管癌患者存在营养不良和摄入不足的问题。PG-SGA与患者的饮食摄入密切相关。本研究结果将有助于医护人员预防营养不良并改善食管癌住院患者的营养状况。此外,应提高公众对将体重减轻视为食管癌早期症状的认识,以及对术前营养评估工具用于营养评估和营养不良管理的认识。

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