Iwasa M
Nihon Geka Gakkai Zasshi. 1983 Oct;84(10):1031-41.
We studied on 66 patients with esophageal cancer with preoperative enteral hyperalimentation by elemental diet, comparing with 64 patients without it, and the following results were obtained; Items such as TP, Alb, etc. in surviving patients, as well as those who died within 3 months, were worse immediately before operation than those at the time of admission when neither TPN nor ED was yet in use. In 35 of 66 patients, there were significant differences between the patients with or without postoperative complications, and who were died after surgery, in arm circumference (AC), triceps skinfold (TSF), arm muscle circumference (AMC), albumin (Alb), prealbumin (PA), retinol-binding protein (RBP) and PPD skin test. From the studies of about 60 items with the computer, the index as follow were obtained. Nutritional Assessment Index (NAI) = 2.64 AC + 0.6 PA + 3.76 RBP + 0.017 PPD - 53.8 Nutritional status of the patients was divided retrospectively broadly to three groups, good (NAI greater than or equal to 60), intermediate (60 greater than NAI greater than or equal to 40), and poor (40 greater than NAI) in preoperative period. The incidence of postoperative complications and mortality rates were reflected significantly in NAI. NAI would be useful to know prospectively the probability of all kinds of postoperative complications as well as estimating the nutritional assessment.
我们对66例食管癌患者进行了术前要素饮食肠内高营养治疗的研究,并与64例未进行该治疗的患者进行了比较,结果如下:存活患者以及术后3个月内死亡患者的总蛋白(TP)、白蛋白(Alb)等指标,在术前即刻比入院时尚未使用全胃肠外营养(TPN)或要素饮食(ED)时更差。66例患者中有35例,术后有或无并发症以及术后死亡患者在臂围(AC)、三头肌皮褶厚度(TSF)、上臂肌肉围(AMC)、白蛋白(Alb)、前白蛋白(PA)、视黄醇结合蛋白(RBP)和结核菌素纯蛋白衍生物(PPD)皮肤试验方面存在显著差异。通过计算机对约60项指标进行研究,得出如下指数。营养评估指数(NAI)=2.64AC + 0.6PA + 3.76RBP + 0.017PPD - 53.8。术前患者的营养状况可回顾性地大致分为三组:良好(NAI大于或等于60)、中等(60>NAI大于或等于40)和较差(40>NAI)。术后并发症的发生率和死亡率在NAI中得到显著反映。NAI有助于前瞻性地了解各种术后并发症的可能性以及评估营养状况。