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胃癌患者 278例에 對한 手術前 營養狀態에 關하여

Preoperative Nutritional State in Gastric Cancer

대한외과학회지 1966년 8권 11호 p.639 ~ 643
최국진,
소속 상세정보
최국진 (  ) - 서울대학교 의과대학 외과학교실

Abstract


Author has made a statistical and clinical sudy on the preoperative nutritional state of 278 patients with gastric cancer, who were admitted to the S.N.U. Hospital during he past 5 years and 5 months from Jan, 1960. to May, 1965. In further analysis, the relationship between the preoperative state of nutrition and the progress of cancer was observed.
The state of nutrition was evaluated according to the state of hydration, the level of hemoglobin, the level of serum protein and serum albumin.
In this series, moderate to severe dehydration, less than 600 ml. of urine amount per day, was noted in 12.6% and was somewhat more marked in the incurable cases. But no significant correlation between the state of hydration and the spread of cancer was observed.
Anemia was more frequently noted in man(67.3%), than women(42.0%), giving a total of 59.3%(165 cases). (Hb 12.0 gm/dl in men, 10.0 gm/dl in women). There was somewhat signifi-cant correlation between anemia and progress of cancer. And preponderance of anemia in incurable cases was marked.
Hypoproteinemia, serum protein below 6.0 gm/dl, was present in 36.4% of 261 cases. No significant correlation was observed between the progress of cancer and the incidence of it, but 5 cases whose protein under 4.5 gm/dl were not curable.
On the other hand, hypoalbuminemia, serum albumin below 3.0 gm/dl, was noted in 33.9% of 248 cases and it tends to increase with spread of cancer. Worth mentioning reversed A/G ratio was noted in 64 cases and most of them were incurable. Therefore hypoalbuminemia seems to be the more valuable guide for prognosis than hypoproteinemia in stomach cancer.
Finally, there were also cases of anemia often combined simultaneously with hypoproteinemia (46 cases) or hypoalbuminemia (30 cases) alone or both (19 cases); hypoalbuminemia associated with hypoproteinemia was noticed in 36 cases. But the incidence of the curable cases which underwent radical gastrectomy, subtotal or total, might not be decreased in the above mentioned group than in the group of anemia or hypoalbuminemia alone.

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