Effects of two different reconstruction methods of digestive tract after radical total gastrectomy on quality of life and immune nutrition status in patients with gastric cancer

Q4 Nursing 中华临床营养杂志 Pub Date : 2019-06-30 DOI:10.3760/CMA.J.ISSN.1674-635X.2019.03.008

Tianzhu He, Qiang Hu, Lucy M. Zhang

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引用次数: 3

Abstract

Objective To compare the quality of life, nutritional status and immune function of gastric cancer patients with digestive tract reconstruction using Roux-en-Y anastomosis and uncut Roux-en-Y anastomosis after radical gastrectomy. Methods 86 patients with gastric cancer were selected from May 2015 to June 2017 with radical total gastrectomy. According to the different ways of the reconstruction of the digestive tract, the patients were divided into URY group (non-severed group, 41 patients) and RY group (traditional group, 45 patients). The quality of life of the two groups was compared at 1 month, 3 months and 6 months after operation. The nutritional status of albumin, prealbumin, transferrin, hemoglobin, retinol binding protein and weight, as well as CD4+ lymphocyte, CD8+ lymphocyte, CD4+ / CD8+ ratio, IgG, IgM, IgA and other immune related indexes were observed at pre-operation and 1 month, 3 months and 6 months after operation. Results As for quality of life, the score of diet limitation in group URY was significantly lower than that in group RY at 1 month after operation (P 0.05); As for anxiety, the score of group URY was higher than that in group RY (P 0.05). As for the nutritional indexes, prealbumin in the URY group was higher than that in the RY group at 6 months after operation (P 0.05). There was no statistical significance in immune indexes between the two groups (P>0.05). The postoperative hospitalization time of URY group was less than that of RY group (P 0.05). Conclusion Except for the length of hospitalization and postoperative complications in which uncut Roux-en-Y anastomosis was superior to Roux-en-Y anastomosis, there is no significant difference in quality of life and nutritional and immune indicators between the two alimentary tract reconstruction methods. Key words: Gastric cancer; Digestive tract reconstruction; Quality of life; Nutrition; Immune

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两种消化道重建方式对胃癌根治性全胃切除术后患者生活质量及免疫营养状况的影响

目的比较癌症根治性胃切除术后采用Roux-en-Y吻合和未切Roux-en-Y吻合进行消化道重建的患者的生活质量、营养状况和免疫功能。方法选择2015年5月至2017年6月癌症患者86例，行根治性全胃切除术。根据消化道重建方式的不同，将患者分为URY组（非切断组41例）和RY组（传统组45例）。比较两组患者术后1个月、3个月和6个月的生活质量。观察术前及术后1个月、3个月、6个月血清白蛋白、前白蛋白、转铁蛋白、血红蛋白、视黄醇结合蛋白及体重的营养状况，CD4+淋巴细胞、CD8+淋巴细胞、CD4+/CD8+比值、IgG、IgM、IgA等免疫相关指标。结果在生活质量方面，术后1个月，URY组饮食限制评分明显低于RY组（P＜0.05）；在焦虑方面URY组评分高于RY组（P＜0.05），术后6个月，URY组的前白蛋白水平高于RY组（P＜0.05），两组免疫指标无统计学意义（P＞0.05），术后住院时间少于RY组（P＜0.05）吻合优于Roux-en-Y吻合，两种消化道重建方法在生活质量、营养和免疫指标方面无显著差异。关键词：癌症；消化道重建；生活质量；营养；免疫

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