胃大部切除术病人营养状况研究

目的：研究根治性胃大部切除术对进展期胃癌病人营养及免疫状况的影响。方法：30例接受根治性胃大部切除术的病人，分别于术前及术后第2．7、14d采血，测定血清视黄醇结合蛋白、转铁蛋白、总铁结合力、血清铁、免疫球蛋白。结果：术后2d，所有的营养和免疫指标均急剧下降（P〈0．01）。术后14d，血清视黄醇结合蛋白已恢复到术前水平（P〉0．05），而血清总铁结合力、血清铁、转铁蛋白及各项免疫指标仍未恢复（P〈0．05）。结论：根治性胃大部切除术对胃癌病人营养水平及免疫功能的影响是暂时性的，可逐渐逆转；胃癌病人术后应注重补铁；胃癌病人免疫状况与营养状况呈正相关性。

Nutritional status of patients undergoing subtotal gastrectomy

Objective: To study the nutritional and immunological status of patients with advanced gastric cancer after subtotal gastrectomy.Methods: The blood samples were obtained from 30 patients with advanced gastric cancer before and 2,7,and 14 days after the subtotal gastrectomy.The levels of serum retinol-binding protein,transferrin,total iron-binding capacity,serum iron,and immunoglobulins were deter-mined.Results: The levels of all the nutritional and immunological indicators significantly decreased 2 days after the operation(P < 0.01).The level of serum retinol-binding protein almost returned to the preoperative level 14 days after the operation(P > 0.05),but the levels of total iron-binding capacity,serum iron,transferrin,and immunoglobulins did not recover(P < 0.05).Conclusion: The effects of subtotal gas-tectomy on the nutritional status in patients with advanced gastric cancer are temporary and reversible.Iron supplement should be performed postoperatively in patients with gastric cancer.The immunological status is positively correlated with the nutritional status in patients with gas-tric cancer.