Clinical Research Of Perioperative Nutritional Support In Patients With Cancer

BackgroundClinical nutrition support has developed along with the needs of modern therapey,and its application has been very extensive at present. Most of the patients wih cancer exist different degree of malnutrit,and it is particularly important to give perioperative nutrition support in these patients with gastric cancer, Perioperative reasonable nutrition support can effectively improve the clinical outcomes, inappropriate nutritional support will have on clinical outcomes adversely. Therefore, it is very important to give a preoperative nutritional assessment for the patients with gastric cancer in surgical treatment, and according to the individual nutrition, formulating reasonable nutrition plan is very important of postoperative recovery and prognosis. However, there are still many different controversies and opinions in the perioperative indication, the method and the opportunity of clinical nutrition support. ObjectiveTo Explore the meaning and value of preoperative nutrition evaluation in patients with gastric cancer, and to evaluation the role of perioperative nutritional support to patients with cancer. MethodsMaterials:Selection 50 patients with cancer general during hospitalization from general surgery of shandong university second hospital (2009.5-2011.2), all of the cases have been proven for gastric cancer pathologically. Gender:male 38 cases, women in 12 cases, male and female ratio is 3.2:1; Age:20-30,1 case;30-40 years old,2 cases;40-50 years old,10 cases;50-60 years old,13 cases;60-70,17 cases; 70-80,7 cases,;with an average age of 56.9 years old, median age for 59.0 years old; Tumor site:the distal gastric of the 23 cases; gastric body,20 cases;gastric cardia and bottom,7 cases;Pathologic types:early gastric cancer,2 cases;low differentiated adenocarcinoma,25 cases;the moderately differentiated adenocarcinoma,9 cases;the high differentiated adenocarcinoma,12 cases;a signet ring cell carcinoma,2 cases. Surgical methods:vesssed,33 cases;gastric palliative resection of the full stomach,7 cases; palliative resection of gastric most stomach,7 cases;gastric jejunum anastomosis,3 patients,.Excluding cases with severe cerebrovascular and kidney and liver disease visceral.Methods:Analyzes and summarizes 50 cases of patients with gastric cancer surgery, and evaluation nutritional status with the application method of the SGA, and give reasonable clinical nutrition support to perioperative patients with gastric cancer, to observe the influence of the perioperative nutritional support to hemoglobin, albumin, former albumin and time of the postoperative recovery of gastrointestinal function, the length of days and surgical complications, etc.ResultsThere are different degree of malnutrition in the patients with stomach cancer, after application SGA method to assess the incidence of malnutrition, mild-to-moderate about 52%, severe malnutrition is the incidence of 12.0%; All indexes appear different degree of decline of the stomach surgery patients after operation, preoperative nutritional status has obvious improvement after giving appropriate nutritional support(P<0.05), it is more apparent to patients of severe malnutrition, relatively minor to patients of good nutrition;There is non-significance difference beteen the time of the postoperative recovery of gastrointestinal function and the length of days (P>0.05), incidence rate of postoperative complications:16.67%,15.38%,16.67%, no significant difference (P>0.05).ConclusionThere are different degree of malnutrition in the patients with stomach cancer, with high incidence of malnutrition.lt can provide effective guidance by evaluating the nutrition state of patients with cancer with proper nutrition evaluation method, and SGA can give preliminary nutrition evaluation to patients with gastric cancer; Perioperative reasonable nutrition support can effectively improve the nutritive condition, accelerate the postoperative rehabilitation process, reduce postoperative complications, shorten the length of time, but it is not obvious to patients of good nutrition.