Roth E, Funovics J, Winter M, Schulz F, Huk I, Schemper M, Fritsch A
Langenbecks Arch Chir. 1982;357(2):77-84. doi: 10.1007/BF01237453.
The nutritional status and skin reactivity of 82 cancer patients were determined before surgery and compared with the postoperative complication rate. The nutritional status of 47 patients was evaluated by weight, height, weight-loss, arm muscle circumference, triceps skin-fold measurements, serum albumin, pre-albumin, retinolbinding protein, tranferrin, and cholinesterase. In 35 patients protein catabolism was assessed by the urea production rate (catabolism greater than 15 g/d). Immunity was assessed by the total lymphocyte count and a skin reactivity test. Using these criteria, 55% of the patients were malnourished. Curative operations could only be carried out in 17.4% of the malnourished, but in 50% of the normally nourished patients (P less than 0.0001). Postoperative complications were increased in malnourished patients (47%) when compared with normally nourished patients (20%, P less than 0.05). In anergic and malnourished cancer patients no curative surgical treatment was possible. Due to the increased postoperative complication rate in malnourished cancer patients, nutritional assessment, including the determination of cellular immunity should be performed after admission.
对82例癌症患者术前的营养状况和皮肤反应性进行了测定，并与术后并发症发生率进行比较。47例患者的营养状况通过体重、身高、体重减轻情况、上臂肌肉周长、肱三头肌皮褶厚度测量、血清白蛋白、前白蛋白、视黄醇结合蛋白、转铁蛋白和胆碱酯酶进行评估。35例患者通过尿素生成率评估蛋白质分解代谢（分解代谢大于15g/d）。通过总淋巴细胞计数和皮肤反应性试验评估免疫功能。根据这些标准，55%的患者存在营养不良。根治性手术仅能在17.4%的营养不良患者中进行，但在营养正常的患者中为50%（P<0.0001）。与营养正常的患者（20%，P<0.05）相比，营养不良患者的术后并发症增加（47%）。对于无反应性且营养不良的癌症患者，无法进行根治性手术治疗。由于营养不良的癌症患者术后并发症发生率增加，入院后应进行包括细胞免疫测定在内的营养评估。
