胃癌和贲门食管交界癌患者术后并发症的人体测量和生物变形预测指标

Ekaterina A. Gorbunova, Sergei S. Startsev, I. P. Safontsev, R. Zukov
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引用次数: 0

摘要

背景:胃癌和贲门食管癌手术治疗最常见的腹腔内并发症是术后急性胰腺炎和腹腔脓肿。目的:确定并研究胃癌和贲门食管交界处癌患者术后复杂病程的人体测量和生物变形预测因素。材料与方法:研究对象为 250 名胃癌和贲门食管交界处癌患者,其中男性 123 名,女性 127 名。所有受试者均接受了根治性手术治疗。术后,记录了 40 名患者的术后并发症。所有受试者都接受了人体测量和生物阻抗检查。对身高和体重、胸部横径、肩宽和骨盆宽、腰围和臀围以及身体形态进行了测定。生物阻抗检查在术前和术后进行,使用的是国产软硬件结合的综合设备,可测定身体成分组成和相位角值。阻抗相位角反映了人体的新陈代谢率。使用描述性统计方法对结果进行统计处理。使用了 Shapiro-Francia 检验、Kolmogorov-Smirnov 检验、学生 t 检验、Mann-Whitney 检验和逻辑回归法。差异以 P 0.05 为有统计学意义。结果:妇科畸形体型的女性在术后 12-14 天内,活跃细胞和骨骼肌质量的相对值显著下降(P=0.001;P=0.001),相角值也显著下降(P=0.001)。雄性体型男性的特点是,活性细胞质量(p=0.001)和相位角的相对值显著下降,直至术后 12-14 天(p=0.001)。妇形形态的女性术后出现并发症的几率是雄形形态女性的 4 倍(p=0.001)。中形态身体形态的男女代表在整个术后期间的生物阻抗测量值都很稳定。结论:在腹腔镜手术中,男性和女性的低相位角值以及女性的典型妇科形态体型可作为胃癌和贲门食管交界处癌患者术后并发症高风险的预测指标。
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Anthropometric and bioimpedansometric predictors of postoperative complications in patients with gastric and cardioesophageal junction cancers
BACKGROUND: Among the most common intra-abdominal complications of surgical treatment of gastric and cardioesophageal junction cancers are acute postoperative pancreatitis and abdominal abscesses. AIM: Identification and study of anthropometric and bioimpedansometric predictors of the complicated course of the postoperative period in patients with gastric and cardioesophageal junction cancers. MATERIAL AND METHODS: 250 patients with gastric and cardioesophageal junction cancers, 123 men and 127 women, were examined. All subjects underwent radical surgical treatment. In the postoperative period, postoperative complications were recorded in 40 patients. All subjects underwent anthropometric and bioimpedance examination. Height and body weight, transverse diameter of the chest, width of the shoulders and pelvis, waist and hip circumference, and body morphotype were determined. Bioimpedansometric examination was carried out before surgery and in the postoperative period using a domestic hardware and software complex with determination of the body component composition and the phase angle value. The phase angle of impedance reflected the metabolic rate in the body. The results were statistically processed using descriptive statistics methods. The Shapiro–Francia, Kolmogorov–Smirnov tests, Student's t-test, Mann–Whitney test, and the logistic regression method were used. Differences were considered statistically significant at p 0.05. RESULTS: Women of the gynecomorphic body type were characterized by a significant decrease in the relative values of active cellular and skeletal muscle mass (p=0.001; p=0.001), and the phase angle value until 12–14 days after surgery (p=0.001). Men of the andromorphic body type were characterized by a significant decrease in the relative values of active cell mass (p=0.001) and the phase angle until 12–14 days after surgery (p=0.001). In women of a gynecomorphic morphotype, the likelihood of postoperative complications was 4 times higher than in women of an andromorphic morphotype (p=0.001). Representatives of the mesomorphic body morphotype of both sexes were characterized by stable bioimpedance measurements during the entire postoperative period. CONCLUSION: Low values of the phase angle in men and women, as well as the classic gynecomorphic body type in women can be used in oncoabdominal surgery as predictors of a high risk postoperative complications developing in patients with gastric and cardioesophageal junction cancers.
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