接受部分胃切除手術的胃癌病患術後進食情況及其相關因素之探討

Oral Intake for Patients with Gastric Cancer after Subtotal Gastrectomy

本研究之目的為瞭解胃癌病人接受胃部切除手術後，進食胃切除後飲食之情形及影響因素。本研究採立意取樣，以某醫學中心診斷胃癌並接受胃切除手術後，進食胃切除後飲食的36位病人為研究樣本，依所進食的餐別分為兩組（第一組進食5天，第二組進食3天）。結果顯示，第一組病人在術後5天之平均總進食量介於1085.2～1780.7公克，第二組病人術後3天之平均總進食量介於1229.5～1621公克，兩組病人隨著進食日進展其進食量有顯著增加。第一組病人在進食第5天時的腸胃不適症狀及嚴重度，與進食總量之間呈現顯著正相關，而第二組病人則無。病人的年齡、過去飲食習慣、對飲食的滿意度與進食量之間亦無顯著相關。在進食的第二天，女性病人的進食量顯著低於男性病人。而在體重方面，兩組病人在出院日所測得的體重顯著低於入院日及手術前日的體重。而出院日之白蛋白值稍低於入院日，但無顯著差異。總進食量與出院日之白蛋白值及體重呈現顯著正相關，本研究結果可作為接受胃切除手術後病人飲食量之參考設計。

The purpose of this study was to 1) explore the post-gastrectomy (PG) oral intake of gastric cancer patients who received subtotal gastrectomy, and 2) explore factors correlated to such oral intake. Thirty-six patients were recruited into this study from a medical center in Taiwan. Patients were divided into two groups: one group of patients had a PG diet for 5 days; the other group for 3 days. Results demonstrated that the mean amount of food intake ranged from 1085.2 to 1780.7 grams for the 5-day group, and from 1229.5 to 1621 grams for the 3-day group. For both groups, the amount of food intake significantly increased as the number of days progressed. A significant positive correlation between amount of PG diet intake and severity of GI symptoms was found at day five for the 5-day group; no significant correlation between intake and severity of symptoms was found in the 3-day group. At day two, the amount of diet intake of female patients was lower than that of male patients. No significant correlation was found among age, diet habits, diet satisfaction, and amount of PG diet intake. Body weight on discharge day was significantly lower than on admission and on the day of surgery. The albumin level and body weight on discharge day was slightly lower than on admission day; however, no significant difference was found. A significant positive correlation was found between the amount of diet intake and albumin level on the day of discharge. Findings serve as a reference for planning care and treatment of post-subtotal gastrectomy patients.