| Objective: To study the impact of advanced gastric cancer patients perioperative nutrition support on nutritional status and quality of life,so as to provide evidence for improving malnutrition and enhancing the quality of life of advanced gastric cancer.Method: Select 156 patients diagnosed with advanced and directly line of surgical treatment of gastric cancer patients(c T3/4,N0/+,M0). By using patient-generated subjective global assessment,PG-SGA detected the existence of nutritional risk patients randomly divided into two groups, the research group: 1 week before surgery in patients with 10% glucose was given 500 ml/d, in addition to the regular diet daily oral extra power to enteral nutrition mixed suspension(TPF) 500 ml for 7d, 24 h after surgery first at 500 ml 5% glucose saline nasal drip jejunum nutrition tube at a constant speed slow(about 30ml/h), gradually increase to the biggest drip speed up to 125 ml/h, gradually increase the total amount until the 2000 ml/d. Generally 3~5 days after surgery can transition to full enteral nutrition, 7~9 days to maintain normal diet. Enteral nutrition in the process of transition heat and lack of nitrogen by the parenteral nutritional supplement. The control group :preoperative 1 week to give 10% glucose 500 ml/d and regular diet,the other treatment is the same as research team.To observe and record the patient’s ALB, PA, TLC, body mass index(BMI), upper arm week middle diameter(MAC), triceps skin fold(TSF) and arm muscle weeks diameter(MAMC) when on admission, preoperative 1d postoperative 1 d and 8 d,and Statistical analysis of the data of PG-SGA, QLQ-STO22 Chinese version when on admission and postoperative 8d.1 There is no difference in the aspect of age、sex、 operation time about two groups of patients and be completed as planned.2 By repeated measures analysis of variance at the same time factor group and control group in three indicators(Alb),(PA),(TLC) are statistical differences( P<0.05), the team is better than that of control group. Postoperative ld two groups of the indicators are significantly lower compared with preoperative(P<0.05). Compared with preoperative 1 d for postoperative 8 d in the two groups after each index has rebounded significantly(P<0.05), postoperative 8 d team of the above three kinds of nutrition indicators recovery were better than the control group. The team recovered to close to preoperative levels, but the control group is still in a lower level.3 The research group is better than that of control group in the following areas MAC, TSF, MAMC, BMI, and hand grip strength,both of preoperative 1 d and postoperative 8. But the result has no obvious statistical significance. Postoperative 8 d two groups all the indexes compared with preoperative 1 d decreases obviously, significant difference, statistically significant(P<0.05).4 On admission, two groups of PG-SGA score respectively(7.48±3.04)(6.49±3.15), which belong to the mild malnutrition or suspicious malnutrition no statistical difference between the two(P<0.05). Postoperative 8 d two groups of PG-SGA score respectively(12.47±2.94)(11.27±3.04), belong to severe malnutrition, In the component score,postoperative 8 d score is less than the control group with statistical significance(P<0.05).5 Postoperative 8 d two groups of QOL-STO22 score respectively(18.77±7.62)(18.69±7.71), Significantly higher than the two groups of preoperative QLQ-STO22 score(13.65±6.02)(13.77±6.15mm), statistically significant difference(P<0.05). Preoperative and postoperative 8 d all the scores between the two groups and each item of dimension score had no statistical significance.Conclusions: Compared with preoperative,postoperatively in patients with advanced gastric cancer nutritional status are significantly lower in the short term. Nutritional status in patients with biochemical indicators haveResults: improved, through a systematic postoperative enteral parenteral nutrition support. while there is still a preoperative declined obviously. Advanced gastric cancer patients quality of life is poorer, less in the short term after the surgery. Preoperative enteral nutrition is not significantly positive influence on postoperative short-term quality of life. Preoperative enteral nutrition support group in patients with perioperative nutrition laboratory index, subject evaluation rating scale and so on is better than that of pure postoperative enteral nutrition support group. Preoperative enteral nutrition support plays a positive role to improve the perioperative nutrition, is a reasonable way of nutritional support. |
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