Preoperative Nutritional Liver Cancer Risk Assessment And Nutrition Intervention On Body Composition

ObjectiveNutritional risk assessment of liver cancer patients using nutritional risk screening tool NRS2002, take the body measurement, laboratory examination and body composition analysis on nutritional status of patients with self evaluation;Nutritional intervention for patients with nutritional risk, comparison of changes in body composition index of patients with liver cancer before and after intervention, to provide clinical evidence for reducing perioperative nutritional risk in patients with hepatocellular carcinoma.Subjects and Method1. Liver cancer patients nutritional risk assessment and analysis Continuous sampling point included in Gastroenterology, Hepatobiliary Medicine from August 2014 to August 2015 a total of 164 cases of liver cancer patients in Qilu Hospital of Shandong University, applications NRS2002 its nutritional risk screening, determine whether there is nutritional risk, and compare the patient’s gender, age, height, weight, body mass index, education level, serum albumin, prealbumin, hemoglobin, total lymphocyte count, coagulation and body composition, etc., comprehensive Evaluation of the nutritional status of the patient.2. The relationship between body composition changes in patients with liver cancer and nutrition interventions 123 patients were included in the scope of use NRS2002 after screening,68 cases patients have Nutritional risk in hospitalized, of which 42 males,26 females, mean age 55.8±10.9 years. For patients with liver function and eating by nutritional doctors to give guidance and to develop nutritional support scheme, the total heat 25kcal·kg-1·d-1,0.20g·kg-1·d-1 nitrogen, during the treatment of oral intake, inadequate intake of diet based on conventional patients, daily 9:00,11:30,15:00,17:00 on demand add oral nutritional supplements all nutrients to replenish energy, about 250-500kcal/d, the amount of nitrogen is 1.6～3.2g/d, to meet the physiological requirements, nutritional intervention for 7 days, the body composition body measurement and detection of albumin and hemoglobin of patients, compared the changes of each index camp before and after nutritional support.Result:1. In accordance with standards for 123 patients, and all completed the nutritional risk screening, in 68 cases (55.28%) of the patients with nutritional risk,55 patients (44.72%) had no nutritional risk; less than 60 HCC patients hospitalized patients (52.29%) nutritional risk incidence has a significant difference with more than or equal to 60 years old (78.57%) (P<0.05), that the older than non elderly; there were no significant differences in gender, educational level, height, and fibrinogen in the nutritional risk group and the non nutritional risk group (P>0.05); the difference of body weight and body mass index between the two groups has a significant difference (P<0.05), with the decrease of body weight, body mass index, increased incidence of patients with nutritional risk; the level of serum albumin, hemoglobin, and prealbumin of nutritional risk group were lower than the non risk group, significant difference can be seen in this analyzation (P<0.05); total lymphocyte count, retinol binding protein and prothrombin time in nutritional risk group was higher than that in the non risk group, significant difference can be seen in this analyzation (P<0.05).2. In the case of normal liver cancer patients eat, its nutritional intervention for seven days, body weight, body mass index, white protein, hemoglobin increased significantly than before, and significant difference can be seen in this analyzation (P<0.05), total lymphocyte, total protein, intracellular fluid, body cell mass, protein, body fat content changed little, there were no significant differences(P>0.05); total body water, extracellular fluid, swelling index decrease compared to the previous, significant difference can be seen in this analyzation (P<0.05).Conclusion1. The incidence of nutritional risk was high in the patients with liver cancer, early liver cancer patients should be reasonable nutrition intervention;2. The older you get, the greater the chance of nutritional risk, low weight, low body mass index in patients with liver cancer are more prone to nutritional risk;3. Liver cancer patients can add normal food but insufficient energy feeding conditions of oral nutritional supplements help to improve the nutritional status.