Abstract:

Perioperative nutritional treatment for gastric cancer                LI Guo-li，XIANG Xiao-song. Department of General Surgery，Nanjing General Hospital of the Chinese People's Liberation Army， Nanjing 210002，China
Corresponding author: LI Guo-li，E-mail：drguoli@aliyun.com
Abstract    Gastric cancer could directly consume nutrients， release toxins that metabolic derangements，and affect digestive and absorption functions. Therefore，patients with gastric cancer have different degrees of malnutrition. Malnutrition increases the morbidity of perioperative complications， hinders the adjuvant chemotherapy， and reduces the overall survival rate. The proportions of direct and indirect factors in gastric cancer with different classification， stage and location are different. It needs to be treated differently. Nutritional support can break the vicious cycle between cancer and malnutrition and create opportunities for treatment. Both enteral nutrition and parenteral nutrition have their advantages and disadvantages， but they are all effective methods of nutrition treatment. They should be applied individually and synthetically. On the basis of nutritional support， the combination of arteriovenous chemotherapy for tumor can directly reduce the tumor and relieve symptoms such as gastrointestinal obstruction. The two major factors that cause malnutrition are controlled. Therefore， both nutritional support and adjuvant therapy are important components of the comprehensive treatment of gastric cancer. They are supported by each other.

Key words: gastric cancer, nutritional therapy, perioperative period

摘要：

胃癌病人容易出现营养不良，除了癌消耗营养物质、释放引起代谢紊乱的毒素等直接影响以外，胃癌还会通过影响机体的消化吸收功能导致营养不良。营养不良增加了手术并发症的发生率，制约着辅助治疗的实施，影响总体存活率。不同生长方式、不同分期、不同位置的胃癌，营养不良的成因中直接因素与间接因素所占比例各不相同，需要区别对待。营养支持是打破肿瘤和营养不良间恶性循环的关键，为实施有效的治疗创造机会。肠内营养与肠外营养各有其优缺点，都是有效的营养治疗手段，应根据病人的具体情况个体化选择应用。在营养支持基础上针对肿瘤进行动静脉结合的术前化疗，可以使肿瘤直接影响减轻的同时，消化道梗阻等症状也得到缓解，造成营养不良的两大因素均得到控制，有效地纠正病人的营养不良。因此，营养支持和辅助治疗均是胃癌综合治疗的重要组成部分，相辅相承。

关键词: 胃癌, 营养治疗, 围手术期