营养治疗对胃癌根治术后营养不良患者短期疗效影响的前瞻性随机对照研究  

Influence of nutritional therapy on short-term efficacy of gastric cancer patients with malnutrition after radical gastrectomy:a prospective randomised clinical trial

作　　者：谈善军[1] 严明月 张知格 隋翔宇 刘皓 奚秋磊[1] 吴国豪[1] Tan Shanjun;Yan Mingyue;Zhang Zhige;Sui Xiangyu;Liu Hao;Xi Qiulei;Wu Guohao(Department of Gastrointestinal Surgery General Surgery,Shanghai Clinical Nutrition Research Center,Zhongshan Hospital,Fudan University,Shanghai 200032,China)

机构地区：[1]复旦大学附属中山医院普通外科胃肠外科、上海市临床营养研究中心,上海200032

出　　处：《中华消化外科杂志》2023年第11期1337-1342,共6页Chinese Journal of Digestive Surgery

基　　金：上海市“医苑新星”青年医学人才培养资助计划(沪卫人事[2022]65号);复旦大学附属中山医院优秀青年人才计划(2021ZSYQ14);复旦大学附属中山医院临床研究专项基金(2020ZSLC17、2020ZSLC53);中国食品科学技术学会食品科技基金(2020-16)。

摘　　要：目的探讨营养治疗对胃癌根治术后营养不良患者短期疗效的影响.方法采用前瞻性随机对照研究方法.选取2020年12月至2022年12月复旦大学附属中山医院收治的胃癌根治术后营养不良患者的临床病理资料,以随机数字表法分为营养治疗组和对照组.营养治疗组患者出院后给予膳食指导和每天口服营养补充剂,持续90d.对照组患者出院后只给予与营养治疗组相同的膳食指导.观察指标:(1)入组患者分组情况.(2)随访情况.(3)出院90d营养指标比较.(4)出院90d炎症和机体功能指标比较.(5)出院90d临床结局指标比较.正态分布的计量资料以x±s表示,组间比较采用独立样本t检验.偏态分布的计量资料以M(IQR)表示,组间比较采用非参数秩和检验.计数资料以绝对数或百分比表示,组间比较采用χ^(2)检验.等级资料比较采用χ^(2)检验.结果(1)入组患者分组情况.筛选出符合条件的患者187例;男131例,女56例;年龄为(65±12)岁.187例患者中,营养治疗组95例,对照组92例.营养治疗组患者性别(男、女),年龄,心血管合并症,呼吸系统合并症,糖尿病,手术方式(部分胃切除术、全胃切除术),肿瘤分期(Ⅰ期、Ⅱ期、Ⅲ期),体质量,体质量指数(BMI),骨骼肌指数,白蛋白(Alb),血红蛋白(Hb),中性粒细胞和淋巴细胞比值(NLR),6 min步行距离,握力分别为68、27例,(64±12)岁,21例,4例,7例,59、36例,17、27、51例,(59±11)kg、(21.5±3.1)kg/m^(2)、(42±7)cm^(2)/m^(2)、(39±5)g/L、(112±25)g/L、2.3(8.0)、(456±97)m、(29±8)kg;对照组患者上述指标分别为63、29例,(66±13)岁,22例,3例,9例,56、36例,14、24、54例,(58±11)kg、(21.1±2.9)kg/m^(2)、(42±7)cm^(2)/m^(2)、(39±4)g/L、(111±26)g/L、2.2(8.4)、(459±98)m、(29±8)kg;两组患者上述指标比较,差异均无统计学意义(χ^(2)=0.21,t=-1.29,χ^(2)=0.09、0、0.35、0.03、0.51,t=0.80、0.85、0.19、0.14、0.16,Z=-0.28,t=-0.17、0.43,P>0.05).(2)随访情况.187例患者均完Objective To investigate the influence of nutritional therapy on short-term efficacy of gastric cancer patients with malnutrition after radical gastrectomy.Methods The prospective randomized control study was conducted.The clinicopathological data of patients with malnutrition after radical resection of gastric cancer who were admitted to the Zhongshan Hospital of Fudan University from December 2020 to December 2022 were selected.Based on random number table,all patients were allocated into the nutritional therapy group and the control group.Patients in the nutritional therapy group were given dietary guidance and daily oral nutrition supplements for 90 days after discharge,while patients in the control group were only given the same dietary guidance.Observation indicators:(1)grouping situations of the enrolled patients;(2)follow-up;(3)comparison of nutritional indicators at 90 days after discharge;(4)comparison of inflammation and physical function indicators at 90 days after discharge;(5)comparison of clinical outcome indicators at 90 days after discharge.Measurement data with normal distribution were expressed as Mean+SD,and independent sample t test was used for comparison between groups.Measurement data with skewed distribution were expressed as M(IQR),and non-parameter rank sum test was used for comparison between groups.Count data were expressed as absolute numbers or percentages,and chisquare test was used for comparison between groups.Comparison of ordinal data was conducted using the chi-square test.Results(1)Grouping situations of the enrolled patients.A total of 187 patients were selected for eligibility.There were 131 males and 56 females,aged(65+12)years.Of the 187 patients,there were 95 patients in the nutritional therapy group and 92 patients in the control group,respectively.The gender(male,female),age,cases with cardiovascular complications,cases with respiratory complications,cases with diabetes,surgical methods(partial gastrectomy,total gastrectomy),tumor staging(I stage,II stage,II stage),bod

关 键 词：胃肿瘤 手术 营养不良 营养治疗 口服营养补充 

分 类 号：R735.2[医药卫生—肿瘤]