營養介入對於消化道癌病人癒後改善之成效

先前研究顯示消化道癌常因腫瘤位置及治療方式，會影響其進食量，進而造成營養不良。營養不良及相關的併發症對於執行消化癌手術患者來說是一個重要的問題。本研究探討預計接受消化道癌手術切除病灶的病人。手術後開始進食時評估紀錄進食狀況、主觀性整體營養評估表(PG-SGA) 、上肢握力、體重，及個人化營養諮詢；並於術後一個月進行追蹤。評估執行個人化營養諮詢對消化道癌患者手術前後的之差異，以確定營養介入對於消化道癌病人癒後改善之成效。整體而言，消化道癌病人術後熱量、蛋白質攝取量僅達建議量50%及56%，而執行個人化營養諮詢後，術後一個月熱量、蛋白質攝取可達建議量72%及78%（p<0.05）。而術後體重、PG-SGA、上肢握力的變化則未達顯著差異。本研究顯示術後即時營養介入，可利於其他營養素攝取。本研究結果證明，接受手術的消化道癌病人在營養衛教介入後，能增加飲食中熱量及蛋白質攝取量並維持其體重。

關鍵字

消化道癌；手術；營養諮詢；主觀性整體營養狀況評量表；握力

並列摘要

Many researches indicate that patients with gastrointestinal cancer, arising from the tumor location and the side effects of cancer treatment, may affect their food intake, which cause their malnutrition. Malnutrition and their complications are important issues for surgical patients with gastrointestinal cancer. This study explores patients who undergo surgical resection of gastrointestinal cancer. After surgery, postoperative evaluation of food intake status, patient-generated subjective global assessment (PG-SGA), handgrip strength, weight, and nutritional consultation are performed, and follow up one month after the operation. This study explores the differences of food intake status, PG-SGA, handgrip strength, and weight between before and after surgery to determine the effectiveness of nutritional consultation of patients with gastrointestinal cancer. Overall, the amounts of caloric and protein intake of patients with gastrointestinal cancer after surgery is only 50% and 56% of the recommended. However, after the implementation of personalized nutritional consultation, the caloric and protein intake can reach to 72% and 78% (p<0.05) in one month after the surgery. Though there was no statistical difference in other parameters which include postoperative weight, PG-SGA, and upper limb grip strength.This study also shows that nutritional intervention immediately after surgery is beneficial to the intake of other nutrients. The results of this study proves that patients who undergo nutritional consultation after gastrointestinal surgery could increase the intake of calories and protein in the diet and maintain their weight without loss.