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高蛋白口服营养补充剂对胃癌切除术后体重减轻的影响。

Effect of Oral Nutritional Supplements Composed of High Protein on Body Weight Loss After Gastrectomy.

作者信息

Kikuchi Satoru, Takata Nobuo, Kakiuchi Yoshihiko, Kuroda Shinji, Kashima Hajime, Tanabe Shunsuke, Noma Kazuhiro, Takahashi Ayako, Kagawa Shunsuke, Fujiwara Toshiyoshi

机构信息

Department of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan;

Department of Gastroenterological Surgery, Kochi Health Sciences Center, Kochi, Japan.

出版信息

In Vivo. 2025 Jan-Feb;39(1):426-432. doi: 10.21873/invivo.13845.

Abstract

BACKGROUND/AIM: Body weight loss (BWL) after gastrectomy for gastric cancer (GC) decreases postoperative quality of life and survival in patients with GC. This study aimed to evaluate the effect of oral nutritional supplements composed of high protein on BWL in the early period following gastrectomy.

PATIENTS AND METHODS

Pre- and postoperative body weight and skeletal muscle mass were measured using bioelectrical impedance analysis in patients undergoing radical gastrectomy for GC and analyzed retrospectively. Patients received either a regular diet (control group, n=43) or 250 ml (320 kcal) per day of a high-protein oral nutritional supplement (ONS) (22 g protein) in addition to their regular diet (ONS group, n=40) for four weeks after gastrectomy. The actual daily intake of ONS was recorded by patients themselves. The BWL and skeletal muscle loss (SML) at one month after surgery were compared between the two groups.

RESULTS

BWL and SML at one month after surgery were similar between the two groups. In the ONS group, patients were divided into two subgroups (ONS-H and ONS-L) according to whether their ONS intake amount was above or below the average value of 216 kcal. The ONS-H group (ONS intake ≥216 kcal) showed significantly lower BWL compared to the control group (-4.6±2.6% vs. -6.2±2.5%; p=0.03). Moreover, the ONS group showed significantly lower BWL at one month after surgery than the control group in cases of total or proximal gastrectomy (-5.9±3.0% vs. -7.8±1.9%; p=0.04), although no significant difference was observed between the two groups in distal gastrectomy. The hematological nutritional parameters were similar between the two groups.

CONCLUSION

The administration of ONS composed of high protein for four weeks after gastrectomy did not improve BWL at one month after gastrectomy. However, adequate amount of ONS intake and ONS intake after total or proximal gastrectomy might improve BWL.

摘要

背景/目的:胃癌(GC)胃切除术后体重减轻(BWL)会降低GC患者的术后生活质量和生存率。本研究旨在评估高蛋白口服营养补充剂对胃切除术后早期BWL的影响。

患者与方法

对接受GC根治性胃切除术的患者,使用生物电阻抗分析测量术前和术后体重及骨骼肌质量,并进行回顾性分析。胃切除术后四周,患者接受常规饮食(对照组,n = 43)或除常规饮食外每天补充250毫升(320千卡)高蛋白口服营养补充剂(ONS)(22克蛋白质)(ONS组,n = 40)。ONS的实际每日摄入量由患者自行记录。比较两组术后1个月时的BWL和骨骼肌损失(SML)。

结果

两组术后1个月时的BWL和SML相似。在ONS组中,根据ONS摄入量是否高于或低于216千卡的平均值,将患者分为两个亚组(ONS-H和ONS-L)。ONS-H组(ONS摄入量≥216千卡)的BWL显著低于对照组(-4.6±2.6%对-6.2±2.5%;p = 0.03)。此外,在全胃或近端胃切除的病例中,ONS组术后1个月时的BWL显著低于对照组(-5.9±3.0%对-7.8±1.9%;p = 0.04),尽管在远端胃切除术中两组之间未观察到显著差异。两组的血液学营养参数相似。

结论

胃切除术后四周给予高蛋白ONS并不能改善胃切除术后1个月时的BWL。然而,充足的ONS摄入量以及全胃或近端胃切除术后的ONS摄入可能会改善BWL。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2d42/11705125/c6ae7062b2f6/in_vivo-39-428-g0001.jpg

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