위암환자의 위절제술 전·후 영양상태 평가

Abstract

The purposes of this study were to assess the nutritional status of gastrectomy patients before and after operation following the gastric cancer diagnosis, identify factors influencing their malnutrition, and provide basic data for nutritional interventions. The subjects include 109 patients that received gastrectomy at A Hospital in Busan from August, 2015 to October, 2017. Their nutritional status was evaluated with anthropometric measurements, biochemical data, and PG-SGA (Patient-Generated Subjective Global Assessment) before operation and one & three months after operation. Collected data was analyzed with the SPSS version 18.0 program. The findings were as follows: the subjects were a group of patients that were hospitalized for gastrectomy after the gastric cancer diagnosis, consisting of 78 men and 31 women. Their mean age was 59.55 years. The evaluation results based on their anthropometric measurements show that they made a significant increase in body weight, body mass index, and % ideal body weight one and three months after operation compared with before operation(P<0.001). Their body weight decreased by 4.5 kg and 5.7 kg one and three months after operation compared with before operation. According to their biochemical test results, their TLC and serum albumin decreased one month after operation and recovered three months after operation. Their hemoglobin level dropped one month after operation compared with before operation and rose three months after operation, but it did not make full recovery to the level before operation. Their nutritional status scores based on the PG-SGA results were 3.13 point before operation, 7.61 point one month after operation, and 4.75 point three months after operation, which indicates that their nutritional risk increased one month after operation and recovered three months after operation but not to the level before operation. There were no significant differences in nutritional status changes according to most of the clinical characteristics, but the hemoglobin level of open surgery, EGC, and adjuvant therapy patients was low three months after operation. These findings show the nutritional status of patients according to time and their progress according to their clinical characteristics. There is a need for active nutritional supports for patients in a nutritional risk group before gastrectomy to improve the nutritional status of gastrectomy patients. Ongoing monitoring and nutritional interventions will also be needed according to time to assist their recovery after operation and promote therapeutic effects.