Study on nutritional risk and nutritional support in patients with liver cancer during perioperative period / 中国医师进修杂志

ABSTRACT

Objective:To study the nutritional risk and nutritional support in patients with liver cancer during perioperative period.Methods:In Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical, the clinical data of 507 liver cancer patients who underwent surgery College from January 2019 to January 2020 were retrospectively analyzed. The perioperative nutrition was assessed by nutritional risk screening 2002 (NRS 2002), ≥3 scores was diagnosed nutritional risk, and the nutritional support was counted.Results:Among 507 patients, 82 cases (16.2%) had nutritional risk. There was no statistical difference in rate of nutritional risk between male and female 15.3% (58/379) vs. 18.8% (24/128), χ2 = 0.838, P>0.05. There was no statistical difference in rate of nutritional risk between primary liver cancer patients and secondary liver cancer patients 18.0% (63/350) vs. 12.1% (19/157), χ2 = 2.781, P>0.05. The rate of nutritional risk in ≥ 60 years old patients was significantly higher than that in <60 years old patients 25.9% (62/239) vs. 7.5% (20/268), and there was statistical difference ( χ2 = 31.819, P<0.01). The age, incidence of dystrophy and rate of nutritional support before surgery in patients with nutritional risk were significantly higher than those in patients without nutritional risk (65.3 ± 12.7) years old vs. (55.9 ± 8.9) years old, 13.4% (11/82) vs. 0 and 24.4% (20/82) vs. 2.6% (11/425), and there were statistical differences ( P<0.01); there were no statistical differences in sex composition, tumor origin, rate of nutritional support after surgery and albumin between patients with nutritional risk and patients without nutritional risk ( P>0.05). Among 31 nutritional support patients before surgery, parenteral nutrition (PN) was in 1 case, enteral nutrition (EN) was in 30 cases; among 453 nutritional support patients after surgery, PN was in 297 cases, EN was in 27 cases, and PN + EN was in 129 cases. Conclusions:The incidence of nutritional risk in patients with liver cancer during perioperative period is high, and especially elderly patients should pay attention to nutritional support. NRS 2002 is a powerful tool and should be recommended to use at patients with liver cancer, and provide the evidence of nutritional therapy.