胃癌患者围手术期营养状况对生活质量的影响调查

目的了解胃癌患者围手术期的营养状况和生活质量动态变化情况，探讨胃癌患者围手术期的营养状况与生活质量的关系，为提高患者的生活质量提供依据。方法采用前瞻性调查的方法，使用患者整体营养状况主观评估量表（ScoredPatient—GeneratedSubjectiveGlobalAssessment，PG—SGA）和胃癌患者生活质量特异性量表（QualityofLifeQuestionnaireofStomach22，QLQ—ST022）分别对135例胃癌患者术前1d、术后10d的营养状况、生活质量水平进行测量，并对测量数据进行统计分析。结果患者术前PG—SGA得分为6．71±3．05，为轻度营养不良或可疑营养不良；术后PG—SGA得分为12．82±2．85，为严重营养不良；患者术后PG—SGA总分明显高于术前（t=21．91，P=0．000）。患者术后QLQ—ST022总分（19．69±7．59）明显高于术前QLQ—ST022总分（14．32±5．97），差异具有统计学意义（t=8．21，P=0．000）。方差分析结果显示，不同营养等级患者的生活质量存在差异（F=29．29，P=0．000）。结论胃癌患者围手术期存在营养状况不良，患者生活质量差，术后营养状况和生活质量评分下降，围手术期营养不良的患者的生活质量明显低于营养良好的患者。临床上应重视胃癌患者围手术期的营养支持，以改善手术前后的生活质量。

Effects of nutritional status on the quality of life of patients with gastric cancer in perioperative period

Objective To investigate the nutritional status and quality of life （QOL） of patients with gastric cancer in perioperative period and to analyze the relationship between nutritional status and QOL. Methods A prospective study was performed. One hundred and thirty-five patients with gastric cancer were enrolled in this study. The nutritional status and quality of life, 1 day before operation and 10 days after operation, were assessed by the Scored Patient-Generated Subjective Global Assessment （PG-SGA） and the Quality of Life Questionnaire of Stomach 22 （QLQ-STO22）. Statistical analysis was performed using SPSS 13.0 software. Results In preoperative period, the PG-SGA score was （6.71 ± 3.05）, which belonged to moderate malnutrition. PG-SGA score in postoperative period was （12.82 ± 2.85）, which belonged to severe malnutrition. PG-SGA score in postoperative period was significantly higher than that in preoperative period （t=-21.91, P=0.000）. QOL score in postoperative period （19.69 ± 7.59） was significantly higher than that in preoperative period （14.32 ± 5.97） （t=8.21, P=0.000）. The total scores of QOL showed statistically significant differences in patients with different nutritional statuses （/=29.29, P=0.000）. Condusions Gastric cancer patients＇ nutritional status and QOL are impaired in perioperative period. Compared with preoperative period, the nutritional status and QOL of postoperative period are obviously poorer. The QOL of malnourished patients is worse than well-nourished patients. Therefore, nutritional status is independently and negatively associated with QOL in gastric cancer and improving the status of nutritional should be viewed as an important part in the management of gastric cancer.