结直肠癌患者围手术期体重减轻及其影响因素

Q4 Nursing

中华临床营养杂志 Pub Date : 2019-10-30 DOI:10.3760/CMA.J.ISSN.1674-635X.2019.05.006

Yaqin Chu, Jian Zhao, Zhiwei Jiang

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引用次数: 0

摘要

目的探讨癌症患者围手术期体重减轻及其影响因素，为围手术期营养支持策略的制定和管理提供依据。方法将90例癌症患者分为观察组（n=61）和对照组（n=30），观察组体重减轻程度小于术前体重的5%。采用单因素和多因素分析方法，比较两组大肠癌患者的身体成分变化和体重减轻因素。结果9例癌症患者平均体重减轻2.0kg，围手术期身体成分变化中，体脂、肌肉、蛋白质组含量均明显下降（P＜0.05），术中出血量和术后口服营养摄入依从性是影响癌症患者术后体重减轻程度的危险因素。多因素logistic回归分析显示术中出血量是影响癌症患者术后体重减轻程度的独立因素（P＜0.05）。术中失血是影响围手术期体重减轻程度的独立危险因素。在未来的临床研究和实践中，应加强微创精确的手术治疗，减少术中失血量和手术创伤，并注意患者术后口腔营养的摄入，尤其是老年患者。应针对不同人群进行个性化的饮食指导和管理，改善患者围手术期的营养状况。关键词：结直肠癌癌症；减肥；身体成分；术后恢复增强

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Perioperative weight loss and its influencing factors in patients with colorectal cancer

Objective To investigate the perioperative weight loss and its influencing factors in patients with colorectal cancer, and to provide evidence for the development and management of perioperative nutritional support strategies. Methods Ninety-one patients with colorectal cancer were enrolled and divided into observation group (n=61) with the degree of weight loss less than 5% of preoperative weight and control group (n=30) with the degree of weight loss more than 5% of preoperative weight. Change of body composition and factors of weight loss in patients with colorectal cancer were compared between the two groups by single factor and multivariate analysis. Results Ninety-one patients with colorectal cancer had the average weight loss of 2.0 kg. Of perioperative changes in body composition, the degree of body fat, muscle mass and protein group decreased statistically (P<0.05). Univariate analysis showed that the age, intraoperative blood loss and postoperative oral nutrition intake compliance were the risk factors for the degree of weight loss in patients with colorectal cancer after the operation. Multivariate logistic regression analysis showed that the intraoperative blood loss was an independent influencing factor for the degree of postoperative weight loss in patients with colorectal cancer (P<0.05). Conclusion Age, intraoperative blood loss and postoperative oral nutritional intake compliance may affect the degree of weight loss during perioperative period. Intraoperative blood loss is an independent risk factor affecting the degree of weight loss during perioperative period. In future clinical research and practice, minimally invasive and accurate surgical treatment should be strengthened, the amount of intraoperative blood loss and surgical trauma should be reduced, and the postoperative oral nutrition intake of patients should be paid attention, especially for elderly patients. Personalized dietary guidance and management for different groups should be conducted, and perioperative nutritional status of patients should be improved. Key words: Colorectal cancer; Weight loss; Body composition; Enhanced recovery after surgery

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来源期刊

中华临床营养杂志 Nursing-Nutrition and Dietetics

CiteScore

0.20

自引率

0.00%

发文量

2282

期刊介绍： The Chinese Journal of Clinical Nutrition was founded in 1993. It is the first professional academic journal (bimonthly) in my country co-sponsored by the Chinese Medical Association and the Chinese Academy of Medical Sciences to disseminate information on clinical nutrition support, nutrient metabolism, the impact of nutrition support on outcomes and "cost-effectiveness", as well as translational medicine and nutrition research. It is also a professional journal of the Chinese Medical Association's Parenteral and Enteral Nutrition Branch. The purpose of the Chinese Journal of Clinical Nutrition is to promote the rapid dissemination of knowledge on nutrient metabolism and the rational application of parenteral and enteral nutrition, focusing on the combination of multidisciplinary and multi-regional field investigations and clinical research. It mainly reports on nutritional risk screening related to the indications of parenteral and enteral nutrition support, "cost-effectiveness" research on nutritional drugs, consensus on clinical nutrition, guidelines, expert reviews, randomized controlled studies, cohort studies, glycoprotein and other nutrient metabolism research, systematic evaluation of clinical research, evidence-based case reports, special reviews, case reports and clinical experience exchanges, etc., and has a special column on new technologies related to the field of clinical nutrition and their clinical applications.