胃癌术式对患者术后营养的影响
Effects of Different Surgical Procedures on Digestive and Nutritional Status after Gastrectomy in Patients with Gastric Cancer
-
摘要: 全胃切除对机体的生理干扰较大,破坏了消化道的连续性和完整性,影响食物的消化和吸收,术后患者均有一些并发症出现。如:返流性食管炎、早期或晚期倾倒综合征、顽固性贫血、消化吸收不良以及腹泻、餐后上腹部轻度闷痛、食欲低下等症状,统称为胃切除术后综合征。全胃切除后消化道重建术式已达70多种,以期克服上述并发症。其中保持经十二指肠通路间置空肠(附加/无空肠袋)被认为可以提高患者的生活质量,降低上述并发症。近端或远端胃次全切除术后在残胃和十二指肠间间置一段空肠(附加空肠袋/无袋)可以改善患者的营养状况,提高患者的生活质量。预后营养指数(PNI)、Visik评分、Spitzer指数和欧洲癌症研究治疗机构问卷(EORTCQLQ-C30)都可以被用于评估胃切除术后患者的生活治疗及营养状况。Abstract: Post-gastrectomy syndromes evoked by the loss of several gastric functions after total or subtotal gastrectomy are very common. Different kinds of reconstruction have been developed to overcome this problem. Patients with preservation of the duodenal passage in jejunal interposition with or without a pouch show a better quality of life and minimal postoperative symptoms. A jejunal interposition with or without a pouch after proximal or distal subtotal gastrectomy seems to improve the nutritional state and quality of life. The prognostic nutritional index (PNI), Visik Score, Spitzer Index and The European Organization for Research and Treatment of Cancer (EORTC) questionnaire (QLQ-C30) are available to evaluate the quality of life and nutritional status after gastrectomy.