The Influence Of Nutritional Support For Postoperative Nutritional Status And Quality Of Life In Patients With Gastrointestinal Tumor

Objective: To study the impact of gastrointestinal surgery and chemotherapy for the nutritional status and quality of life of patients;To understand the influence of Nutritional support for Postoperative nutritional status and quality of life in patients with gastrointestinal tumor.This can provide the reference to the long-term treatment and nutritional support for digestive tract cancer patients.Methods: Select 110 patients with gastrointestinal tumor who had elective radical or palliative resection treatment and six consecutive chemotherapy in our hospital from September 2015 to December 2016,randomly divided into two groups,control group: surgical removal of the treatment + standard chemotherapy regimens+ nutrition education + enteral nutrition agent as supplements,the specific practices is on the basis of the control method,supplement enteral nutrition agent from 3 days to 6 months in the process of chemotherapy treatment after the surgery(mainly use 500 mL bottle TPF),the give way according to patients condition.We observed and measured the indicators ALB,PA,HGB,BMI,AC,TSF from patients at 1 day before the surgery and 1 week,1 month,3 months and 6 months after the surgery,we used the Chinese version of PG-SGA?QLQ-C30 questionnaire and analyzed the data with statistical software.Results:1 There was no significant difference(P>0.05)in age,gender,tumor types before surgery of the two groups of patients,then that were comparable,all of them had completed the surgery and 6 course of chemotherapy as planed.2(1)Compare between two groups: There show no significant difference(P>0.05)at the BMI?AC?TSF before the surgery between the two groups.After the surgery,BMI's four measurements of the intervention patients all higher than the control group,so there have statistically significant(P<0.05).One week and one month after the surgery,AC?TSF of the intervention patients show no significant difference(P>0.05)to the control group(P>0.05),three months and six months after the surgery,they are better than the control group and have significant difference(P<0.05).(2)Compare in the group: One week and one month after the surgery,the BMI,AC,TSF of the intervention patients are lower than before the surgery and have significant difference(P<0.05),three months and six months after the surgery,although BMI,TSF are lower than before the surgery,but there show no significant difference(P>0.05),AC's four measurements after the surgery always lower than before the surgery and there have statistically significant(P<0.05);the three index's four measurements of the control group always lower than before the surgery and there have statistically significant(P<0.05).3(1)Compare between two groups: About the laboratory indexes ALB,PA,HGB,there show no significant difference(P>0.05)between the intervention group and the control group,one day before the surgery,one week,one month,three month and six month after the surgery,these laboratory indexes have statistically significant(P<0.05)between the two groups,the intervention group is better than the control group.(2)Compare in the group: One week and one month after the surgery,the ALB,PA,HGB of the intervention patients are lower than before the surgery and have significant difference(P<0.05),three months and six months after the surgery,although these indexes are lower than before the surgery,but there show no significant difference(P>0.05);the three index's four measurements of the control group always lower than before the surgery and there have statistically significant(P<0.05).4(1)Compare between two groups: Total score of the index PG-SGA of the intervention group and the control group are(4.52�3.03)(4.39�2.98)at one day before the surgery,all belong to mild malnutrition or suspicious malnutrition,there have statistically significant(P<0.05).One week,one month,three months and six month after the surgery,total score of the index PG-SGA are(15.38�3.12)(16.52�3.22)?(10.85�2.57)(12.64�3.03)?(8.54�3.21)(10.52�3.12)?(7.65�2.68)(9.57�2.84)respectively,the intervention group is lower than control group and have significant difference(P<0.05).One month,three months and six month after the surgery,self-evaluation of patients and physical grade in the component score of the intervention group are lower than the control group and have significant difference(P<0.05).(2)Compare in the group: One week,one month,three months and six month after the surgery,the two group's total score and the component score of the PG-SGA always higher than before the surgery and have significant difference(P<0.05).5(1)Compare between two groups: One day before the surgery and one week after the surgery,there show no significant difference(P>0.05)at every item of QLQ-C30 between the two groups.One month after the surgery,the intervention group are better than the control group and have significant difference(P<0.05)at the quality character,cognitive function,but the other index show no significant difference(P>0.05).Three months and six months after the surgery,he intervention group are better than the control group and have significant difference(P<0.05)at the quality character,cognitive,social functions,overall quality of life,fatigue,shortness of breath,but the other index show no significant difference(P>0.05).(2)Compare in the group: There show no significant difference(P>0.05)at the emotional function between the two groups through compare the score before the surgery and the score after the surgery four times measurement,there have statistically significant(P<0.05)at the pain symptoms,the score one week after the surgery is higher than one day before the surgery,One month,three months and six month after the surgery,the score of the intervention group are higher than the control group and have significant difference(P<0.05).the other index's four measurements of the control group always higher than before the surgery and there have statistically significant(P<0.05),show that the quality is lower than before the surgery.Conclusion: The nutritional status and quality of life of the gastrointestinal tumor had dramatic decline after the surgery.Enteral nutrition support after the surgery had improved the laboratory indicators of the nutritional status in patients at some extent,but still had dramatic decline after the surgery.Continue enteral nutrition support during the chemotherapy can make the laboratory indicators recovered gradually.A long-term enteral nutrition support can improve some part of the nutritional status and life quality of the gastrointestinal tumor after the surgery.It is feasible to give continue enteral nutrition support for the gastrointestinal tumor after the surgery.