Study On Relationship Between Perioperation Period Of Nutritional Status And Operation Complications Of Radical Gastrectomy Patients

Objective:To investigate the relationship between perioperative period Nutritional status and surgical complications in Patients undergoing Radical gastrectomy.Methods:Use the Subjective global assessment of nutritional status(SGA) to assess the preoperative nutritional status of94patients undergoing Radical gastrectomy.Ddivide the patients into three groups based on the SGA assessment:normal nutrition group,mild malnutrition group and moderate-severe malnutrition. Analysis the incidence of surgical complications in three groups. Collect serum albumin(ALB), serum prealbumin(PA), hemoglobin(HGB), lymphocyte count(TLC) within48hours after admission and48hours postoperative. Ddivide the patients into four groups:normal, Slightly lower, moderately lower and severe lower group. Analysis the incidence of surgical complications in four groups.Results:In the SGA analysis, with increased malnutrition, the incidence of surgical complications in patients was significantly higher (P<0.05). With hemoglobin (HGB), serum prealbumin (PA), serum albumin (ALB), lymphocyte count (TLC) is reduced, the probability of occurrence of surgical complications was significantly higher. In preoperative PA group, X2=7.415P=0.043, P<0.05, it means that the preoperative serum albumin (PA) was significantly associated with operation complications. In48hours postoperative PA group, X2=2.259P=0.335,48hours postoperative PA no was obvious correlation with surgical complications, but in the PA severe lower group the incidence of complications was significantly higher. In preoperative ALB group, X2=7.658P=0.038, it means that the preoperative ALB was significantly associated with operation complications(P<0.05). In48hours postoperative ALB group, X2=11.732P=0.005,it means that the48hours postoperative ALB was significantly associated with operation complications(P<0.05). In preoperative TLC group, X2=8.246P=0.032, preoperative TLC was significantly associated with operation complications(P<0.05). In48hours postoperative TLC group, X2=7.941P=0.037, the48hours postoperative TLC was significantly associated with operation complications(P<0.05). In preoperative HGB group, X2=4.016P=0.224, it means that the preoperative HGB was no obvious correlation with surgical complications(P>0.05), but But with the decrease of HGB, the surgical complication rate is still rising trend is obvious. In48hours postoperative HGB group, X2=6.042P=0.083,there was no obvious correlation between48hours postoperative HGB and surgical complications(P>0.05). Chi-square test analysis showed that the preoperative nutritional status evaluated by SGA, PA, ALB, TLC were associated with operation complications. HGB was no obvious correlation with surgical complications, but with the decrease of HGB, the surgical complication rate is still rising trend is obvious.Conclusion:Analysis shows, there is a correlation between perioperative period Nutritional status and surgical complications in Patients undergoing Radical gastrectomy. The Subjective global assessment of nutritional status (SGA) can reflect the nutritional status of the patients before operation, preoperative SGA was associated with operation complications. The ALB is an important part of hematological system and an Important human nutritional status evaluation. The PA is an acute phase reaction protein. Compared with ALB, PA can be more sensitive to the reactions of protein synthesis in liver function. So PA is a sensitive indicators which can be used to check the body’s recent nutritional status. Lymphocytes are important components of the body’s immune response function. Some factors include inadequate intake of nutrients, malnutrition, stress reaction decrease the synthesis of lymphocytes. perioperation PA, ALB, TLC were associated with operation complications. As a result of the limitation of medical ethics, anemia Patients were treated by erythrocyte Infusion before operation. As a result, perioperation HGB can’t reflect the nutritional status of patients truly. HGB was no obvious correlation with surgical complications, but with the decrease of HGB, the surgical complication rate is still rising trend is obvious. Therefore, using the Subjective global assessment of nutritional status(SGA) to assess the preoperative nutritional status of gastric cancer patients, and tracking and monitoring the indicators for the treatment of gastric cancer perioperative nutritional support and reduce the complications have important guiding significance.