家庭营养支持对胃癌患者术后营养状况和心理痛苦的影响

  目的  了解胃癌术后患者营养不良和心理痛苦状况，观察家庭营养支持对胃癌患者术后营养状况和心理痛苦的影响。   方法  收集2019年9月—2020年8月在蚌埠医学院第一附属医院肿瘤外科和胃肠外科行胃癌根治术患者166例，采用随机数字表法研究对象随机分为观察组和对照组，各83例，对照组给予常规抗肿瘤治疗，观察组在对照组的基础上给予家庭营养支持治疗，收集患者家庭信息及出院时和出院3周后营养指标和心理痛苦指标。   结果  PG-SGA评估和心理痛苦评估结果显示:本次研究对象营养不良发生率为79.5%，心理痛苦阳性率为63.3%。营养不良胃癌患者心理痛苦阳性率(67.4%)较营养良好者(47.1%)高，差异具有统计学意义(P < 0.05)。出院时观察组和对照组患者总蛋白(TP)、白蛋白(ALB)、前白蛋白(PAB)、PG-SGA评分和心理痛苦检出率比较，差异均无统计学意义(均P < 0.05)；3周后，观察组总蛋白(TP)、前白蛋白(PAB)和白蛋白(ALB)较对照组高，观察组营养不良发生率(61.4%)较对照组发生率(80.7%)低，差异具有统计学意义(P < 0.05)。观察组心理痛苦检出率(31.3%)较对照组检出率(53.0%)低，差异具有统计学意义(P < 0.05)。   结论  胃癌术后患者营养不良发生率和心理痛苦检出率高，家庭营养支持能有效改善患者营养状况和降低心理痛苦检出率。 

Effect of home nutrition support on nutritional status and psychological pain of patients with gastric cancer after surgery

  Objective  To investigate the status of malnutrition and psychological distress in patients with gastric cancer after operation and observe the effect of family nutritional support on postoperative nutritional status and psychological distress of patients with gastric cancer.   Methods  A total of 166 patients undergoing gastrectomy in the Department of Oncology and Gastrointestinal Surgery of the First Affiliated Hospital of Bengbu Medical College from September 2019 to August 2020 were collected as the study subjects and randomly divided into experimental group and control group. The patients in the control group were given conventional anti-tumor treatment and patients in the experimental group were given additional home nutrition support treatment on the based on the treatment of the control group. The family information, nutritional and psychological distress indexes of patients were detected at discharge and 3 weeks after discharge.   Results  The results of Patient-Generated Subjective Global Assessment (PG-SGA) and Psychological Distress assessment showed that the incidence of malnutrition was 79.5% and the overall positive rate of psychological distress was 63.3%. The positive rate of psychological distress in malnourished gastric cancer patients (67.4%) was higher than that in well-nourished gastric cancer patients (47.1%, P < 0.05). There were no significant differences in the levels of total protein (TP), albumin (ALB), prealbumin (PAB), PG-SGA score and detection rate of psychological distress between the two groups at discharge (all P < 0.05). After 3 weeks, the levels of total protein (TP), albumin (ALB) and prealbumin (PAB) in the experimental group were higher than those in the control group, and the incidence of malnutrition in the experimental group (61.4%) was lower than that in the control group (80.7%, P < 0.05). The detection rate of psychological distress in the experimental group (31.3%) was lower than that in the control group (53.0%, P < 0.05).   Conclusion  The incidence of malnutrition and the detection rate of psychological pain in patients with gastric cancer after surgery are high. Family nutrition support can effectively improve the nutritional status of patients and reduce the detection rate of psychological pain.