老年胃癌根治术患者术前营养状况与预后及生活质量的关系研究

摘要

Objective To investigate the correlation of pre-operative nutritional status with prognosis and quality of life in elderly patients undergoing radical gastrectomy.Methods From January to December 2016,the nutritional status in 120 elderly patients with gastric cancer was assessed with Nutritional Risk Screening Scale (NRS2002) before radical gastrectomy.According to the results,the patients were divided into a nonnutritional risk group (n=48,NRS2002 ＜ 3 points) and a nutritional risk group (NRS2002 ≥ 3,n=72).The patients were followed up for 2 years.The survival rates 1 and 2 years after the operation and recurrence rate of the two groups were recorded.The quality of life in both groups were evaluated with quality of life scale (QLQ-30).Results The postoperative infection rate was higher in the nutrition risk group than in the non-nutrition risk group (22.06％ vs.3.84％).The survival rates 1 and 2 years after the operation were lower in the nutrition risk group than in the non-nutrition risk group than nutrition risk group (88.23％ vs.100.00％ and 76.47％ vs.96.15％)(P ＜ 0.05).After the operation,the scores of social function,emotional function,cognitive function,role function,physical function,and overall quality of life were (68.9±3.5),(71.2±4.2),(70.8±3.8),(72.2±4.0),(73.2±3.5),and (71.5±3.2) in the nutrition risk group and were (87.9±3.7),(88.9±3.0),(92.2±3.5),(90.5±4.8),(91.2±3.7),and (89.6±4.0) in the non-nutritional risk group (all P ＜ 0.05).Conclusions Pre-operative nutritional status of elderly patients with gastric cancer significantly influences their post-operative survival rate and quality of life.Preoperative nutritional intervention on the patients with nutritional risk will help improve their survival rate and quality of life.%目的 探讨老年胃癌根治术患者术前营养状况与预后及生活质量的关系研究.方法 2016年1至12月对120例老年胃癌根治术患者术前应用营养风险筛查量表(NRS2002)对其营养状况进行评估,并根据评估结果将患者分为无营养风险组(n=48,NRS2002＜3分)及营养风险组(n=72,NRS2002≥3分),对两组患者随访2年,记录两组患者术后1年、术后2年存活率及复发率情况,并应用癌症患者生活质量量表(QLQ-30)对两组患者生活质量进行评价.结果 营养风险组术后感染率为22.06％,显著高于非营养风险组的3.84％,而术后1年、术后2年存活率分别为88.23％、76.47％,明显低于营养风险组的100.00％、96.15％ (P＜0.05);营养风险组患者术后社会功能、情绪功能、认知功能、角色功能、躯体功能等维度评分及总生活质量评分分别为(68.9±3.5)分、(71.2±4.2)分、(70.8±3.8)分、(72.2±4.0)分、(73.2±3.5)分、(71.5±3.2)分,非营养风险组分别为(87.9±3.7)分、(88.9±3.0)分、(92.2±3.5)分、(90.5±4.8)分、(91.2±3.7)分、(89.6±4.0)分,差异均有统计学意义(均P＜0.05).结论 术前营养状况对老年胃癌根治术患者术后存活率及生活质量有明显的影响,术前对老年胃癌营养风险人群加强营养干预将有助于提高患者术后存活率及生活质量.