| Objective:To investigate the dynamic changes of the nutritional intakes,malnutrition prevalence,inflammation scores and quality of life in postoperative gastric cancer patients during chemotherapy.We observed the effect of nutritional therapy on inflammation score and quality of life,explored the feasibility of reducing inflammation score through nutrition treatment so as to provide theoretical basis for improving the prognosis of patients.Method:A total of 366 patients undergoing gastrectomy in the Department of Oncology and Gastrointestinal Surgery,the First Affiliated Hospital of Bengbu Medical College and the Department of Gastrointestinal Surgery,West District of Anhui Provincial Hospital from June 2019 to December 2020,were collected as the study subjects and were randomly divided into experimental and control groups.347 patients completed the experiment,including 166 patients in the experimental group and 181 patients in the control group.The experimental group was given nutritional therapy plan by nutritional therapy group,while the control group was only given routine oral nutrition education.The general information,nutrition intake,nutritional status,inflammatory index and quality of life were collected and compared at the first,third and sixth chemotherapy.Results:Dietary survey:There were no significant differences in the intakes of energy,protein,fat and carbohydrate between the two groups at the first chemotherapy(P>0.05).After nutritional therapy,The intakes of energy,protein,fat and carbohydrate in the experimental group were higher than that in the control group at the third and sixth chemotherapy and the differences were statistically significant(P<0.05).Results of patient subjective global assessment(PG-SGA):With the progress of chemotherapy,the incidence of malnutrition decreased in the experimental group and increased in the control group,the differences were statistically significant(P<0.05).There were no significant differences in the incidence of malnutrition between the two groups at the first chemotherapy(P>0.05),but the incidence of malnutrition in the experimental group were lower than that in the control group at the third and sixth chemotherapy and the differences were statistically significant(P<0.05).Patients who received distal gastrectomy had the lowest incidence of malnutrition.After nutritional therapy,the incidence of malnutrition in patients received different operations in the experimental group decreased during chemotherapy and were lower than that in the control group,the differences were statistically significant(P < 0.05).Inflammation score(NLR):Comparisons within the two group found that the positive rates of NLR in the experimental group and the control group were lower after chemotherapy than that at the first chemotherapy,the differences were statistically significant(P<0.05).Comparisons between the two groups found that there were no significant differences in the positive rates of NLR between the two groups at the first chemotherapy(P>0.05).The positive rates of NLR in the experimental group were lower than that in the control group at the third and sixth chemotherapy and the differences were statistically significant(P<0.05).Quality of life(QLQ-C30)survey:Comparisons within the two group found that there were no significant differences in the overall health scores of the control group(P>0.05),but the overall health scores of the experimental group increased gradually and the differences were statistically significant(P<0.05).With the progress of chemotherapy,the scores of emotional function and physical function of the two groups increased,while the scores of nausea and vomiting,fatigue and loss of appetite decreased,and the differences were statistically significant(P<0.05).Comparisons between the two groups found that there were no significant differences in each dimension of quality of life between the two groups at the first chemotherapy(P>0.05);the overall health,emotional function and physical function scores in the experimental group were higher than those in the control group at the third and sixth chemotherapy and the differences were statistically significant(P<0.05);the nausea,vomiting,fatigue and appetite scores in the experimental group were lower than those in the control group at third and sixth chemotherapy and the differences were statistically significant(P<0.05).Psychological distress(DT)survey:Comparisons within the two group found that the detection rates of psychological pain at the third and sixth chemotherapy were lower than that at the first chemotherapy in the experimental and the control groups and the differences were statistically significant(P<0.05).Comparisons between the two groups found that there were no significant differences in the detection rates of psychological distress between the two groups at the first chemotherapy(P>0.05),but the detection rates of psychological distress in the experimental group were lower than that in the control group at the third and sixth chemotherapy and the differences were statistically significant(P<0.05).Subjective well being(MUNSH)survey:Comparisons within the two group found that the MUNSH scores in the experimental group increased gradually and the differences were statistically significant(P<0.05),while there were no significant difference in the MUNSH scores in the control group(P> 0.05).Comparisons between the two groups found that the MUNSH scores were higher than that in the control group at the third and sixth chemotherapy and the differences were statistically significant(P<0.05).Conclusion:Postoperative gastric cancer patients have low nutrients intake,high incidence of malnutrition,low quality of life scores,high detection rates of psychological distress,low subjective well-being scores.The overall quality of life of the patients was poor.The nutritional therapy during chemotherapy is helpful to improve nutritional status,reduce the positive rate of NLR,improve quality of life,reduce detection rates of psychological distress,and improve subjective well-being.In clinical practice,the ideal nutritional therapy for cancer should achieve the goals of anti consumption,anti inflammation,anti-tumor and improving the overall quality of life. |
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