营养支持对老年胃癌患者术后免疫、营养、炎症及预后的影响。
Impact of nutritional support on immunity, nutrition, inflammation, and outcomes in elderly gastric cancer patients after surgery.
作者信息
Chen Xiao-Wan, Guo Xiao-Chun, Cheng Fen
机构信息
Department of Gastrointestinal Surgery, Hubei Cancer Hospital, Wuhan 430079, Hubei Province, China.
Department of Gastroenterology, The First People's Hospital of Jiangxia District, Wuhan 430200, Hubei Province, China.
出版信息
World J Gastrointest Surg. 2024 Jul 27;16(7):2175-2182. doi: 10.4240/wjgs.v16.i7.2175.
BACKGROUND
Postoperative rehabilitation of elderly patients with gastric cancer has always been the focus of clinical attention. Whether the intervention by a full-course nutritional support team can have a positive impact on the postoperative immune function, nutritional status, inflammatory response, and clinical outcomes of this special population has not yet been fully verified.
AIM
To evaluate the impact of full-course nutritional support on postoperative comprehensive symptoms in elderly patients with gastric cancer.
METHODS
This is a retrospective study, including 60 elderly gastric cancer patients aged 70 years and above, divided into a nutritional support group and a control group. The nutritional support group received full postoperative nutritional support, including individualized meal formulation, and intravenous and parenteral nutrition supplementation, and was regularly evaluated and adjusted by a professional nutrition team. The control group received routine postoperative care.
RESULTS
After intervention, the proportion of CD4+ lymphocytes (25.3% ± 3.1% 21.8% ± 2.9%, < 0.05) and the level of immunoglobulin G (12.5 G/L ± 2.3 G/L 10.2 G/L ± 1.8 G/L, < 0.01) were significantly higher in the nutritional support group than in the control group; the changes in body weight (-0.5 kg ± 0.8 kg -1.8 kg ± 0.9 kg, < 0.05) and body mass index (-0.2 ± 0.3 -0.7 ± 0.4, < 0.05) were less significant in the nutritional support group than in the control group; and the level of C-reactive protein (1.2 mg/L ± 0.4 mg/L 2.5 mg/L ± 0.6 mg/L, < 0.01) and WBC count (7.2 × 10/L ± 1.5 × 10/L 9.8 × 10/L ± 2.0 × 10/L, < 0.01) were significantly lower in the nutritional support group than in the control group. In addition, patients in the nutritional support group had a shorter hospital stay (10.3 d ± 2.1 d 14.8 d ± 3.6 d, < 0.05) and lower incidence of infection (15% 35%, < 0.05) in those of the control group.
CONCLUSION
The intervention by the nutritional support team has a positive impact on postoperative immune function, nutritional status, inflammatory response, and clinical outcomes in elderly patients with gastric cancer.
背景
老年胃癌患者的术后康复一直是临床关注的焦点。全程营养支持团队的干预是否能对这一特殊人群的术后免疫功能、营养状况、炎症反应及临床结局产生积极影响，尚未得到充分验证。
目的
评估全程营养支持对老年胃癌患者术后综合症状的影响。
方法
本研究为回顾性研究，纳入60例70岁及以上的老年胃癌患者，分为营养支持组和对照组。营养支持组术后接受全程营养支持，包括个性化膳食制定、静脉及肠外营养补充，并由专业营养团队定期评估和调整。对照组接受术后常规护理。
结果
干预后，营养支持组CD4+淋巴细胞比例（25.3%±3.1%比21.8%±2.9%，P<0.05）及免疫球蛋白G水平（12.5g/L±2.3g/L比10.2g/L±1.8g/L，P<0.01）显著高于对照组；营养支持组体重变化（-0.5kg±0.8kg比-1.8kg±0.9kg，P<0.05）及体质指数变化（-0.2±0.3比-0.7±0.4，P<0.05）低于对照组；营养支持组C反应蛋白水平（1.2mg/L±0.4mg/L比2.5mg/L±0.6mg/L，P<0.01）及白细胞计数（7.2×10⁹/L±1.5×10⁹/L比9.8×10⁹/L±2.0×10⁹/L，P<0.01）显著低于对照组。此外，营养支持组患者住院时间较短（10.3d±2.1d比14.8d±3.6d，P<0.05），感染发生率低于对照组（15%比35%，P<0.05）。
结论
营养支持团队的干预对老年胃癌患者术后免疫功能、营养状况、炎症反应及临床结局有积极影响。
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