| Purpose For different cTNM staging of gastric cancer patients for nutritional assessment, and take theclinical significance of rational nutrition support.Methods 235cases of gastric cancer patients were selected who hospitalized in our hospital for surgical treatment between January 2012 and December 2014.213 cases into groups actually o 213 patients were divided into groups according to clinical staging gastric cancer cTNM diagnostic criteria,28 patients were gastric cancer stage I, accounting for 13.15%; 28 patients were gastric cancer stage Ⅱ, accounting for 13.15%; 118 patients were gastric cancer stage Ⅲ, accounting for 55.40%; 39 patients were gastric cancer stage IV, accounting for 18.31%. According to the hospitalized patients with nutritional risk screening score touting NRS2002 screening index,recorded general information of each gastric cancer patient, and all information on the screening table; screened each gastric cancer patient. Recorded-score points. Recorded index of albumin and albumin, retinol binding protein values of per patient from the nutrition state of morning venous blood collected to do the test of first day in hospital,preoperative 1 day and postoperative 7 days.Combining with the patients and their willingness to give enteral nutrition and parenteral nutrition support. Records complications of patients, including incision dehiscence, incision infection, abdominal abscess, pulmonary infection, anastomotic leakage, urinary tract infection, gastric paralysis syndrome, anastomotic bleeding, vein thrombosis of lower limb, intestinal obstruction and cardiopulmonary function not congruent. Record the patients’hospitalization days. This study applied SPSS16.0 software for statistical analysis, used mean +/- standard deviation description for measuring data and analyzing variance; Count data by chi-square test,used two independent samples t test for comparison between groups.Results Among gastric cancer patients with nutritional risk,15 people were Ⅱ stage in clinical stage, accounting for 53.57%,17 people were Ⅲ stage, accounting for 60.71%,78people were III stage, accounting for 66.10%,28 people were IV stage, accounting for 71.79%; Among gastric cancer patients with no nutritional risk,13 people were Ⅰ stage in clinical stage, accounting for 46.43%,11 people were Ⅱ stage, accounting for 39.29%,40 people were Ⅲ stage, accounting for 33.90%,11 people were Ⅳ stage, accounting for 28.21%. Nutritional risk of hospitalized patients with gastric cancer was higher, incidence of nutritional risk was associated with tumor stage, nutritional risk proportion of late patients was higher.Compared gastric cancer patients of Ⅰ, Ⅱ, Ⅲ, Ⅳ period different staging were at risk of nutrition or not, the difference had statistical significance (P< 0.05).The difference of figure of albumin, prealbumin, retinol binding protein of gastric cancer patients with different clinical stage was big,the difference had statistical significance (P< 0.05).Later the stage was, lower the figure was. After giving reasonable nutrition therapy, the figure of albumin, prealbumin, retinol binding protein of gastric cancer patients indifferent clinical stage in preoperative 1 day and postoperative 7 days were close, the difference had no statistical significance (P> 0.05). It showed that reasonable nutrition reduced the difference of blood nutrition index of gastric cancer patients in different clinical stage.The analysis of complication rates of gastric cancer patients in different clinical stage after reasonable nutrition had no statistical significance (P> 0.05). Ⅰ, Ⅱ period had less cases patients, the number of complications cases were small, a total of 7 patients with gastric cancer clinical I complications, Ⅱ period, a total of 9 patients with complications. Ⅲ Ⅳ period had more cases patients, the number of complications cases were large,a total of 23 patients with gastric cancer clinical Ⅲ occurs concurrent replaced the disorder, Ⅳ period, a total of 15 patients with complications,but the proportion had no significant difference after statistics analysis.The difference of preoperative pathological staging and the postoperative pathological staging number was small,it showed the comparison had no statistical significance (P> 0.05), preoperative stage was more accurate. After given reasonable nutrition treatment postoperative hospital stay of gastric cancer patients in different clinical stage was close, the difference had no statistical significance (P> 0.05).Conclusion1. Nutritional risk of gastric cancer patients in different clinical stage (cTNM) is different, later the stage is,higher the incidence of nutritional risk is.2.The comparison of albumin, prealbumin, retinol binding protein of gastric cancer patients in different stage (cTNM) admitted to hospital had statistical significance.later the stage is,worse the nutrition is. The comparison of albumin, prealbumin, retinol binding protein in preoperative 1 day and postoperative for 7 days has no statistical difference, it shows that reasonable nutrition has clinical significance.3.The incidence of postoperative complications patients with gastric cancer in different clinical stages (cTNM) has no statistical difference after reasonable nutrition.4.After having nutritional risk screening and given reasonable nutrition,postoperative hospital stay of patients with gastric cancer in different clinical stages (cTNM) has no statistical differences.5.Diffierent nutritional risk was found in patients with diffierent clinical stages (cTNM), nutritional risk screening should be done preoperatively to assess nutritional status.To prevent bad outcomes from happening, a reasonable nutrition support is needed before and after operation.. |
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