Correlation Between Cachexia and Changes of Physical Fitnessin the Patients with Pancreatic and Periampullary Tumor During Three months After Operation

• Main Authors: Yan-Ting Liou, 劉彥廷
• Other Authors: Shiow-Ching Shun
• Format: Others
• Language: zh-TW
• Published: 2016
• Online Access: http://ndltd.ncl.edu.tw/handle/61215177094919026604

碩士 === 國立臺灣大學 === 護理學研究所 === 104 === Cachexia is the common syndrome among the patients with pancreatic and periampullary tumor before surgery. Since the process of the wound healing and the recovery in physical fitness during the post-operation, cachexia is easily ignored. Consequently, cachexia strongly impacts the quality of life and even the survival rate. However, there is no study to explore the correlation between cachexia and the changes of physical fitness in the patients with pancreatic and periampullary tumor during operation. Therefore, the purpose of this study was to explore (1) the prevalence and severity of cachexia before operation, (2) the change of physical fitness during three months after operation, and (3) the correlation between cachexia and the change of physical fitness within three months. A longitudinal designed study was conducted on the patients with pancreatic and periampullary tumor undergoing the surgery in the surgery outpatient. The data were collected four times at peri-operation (T0) and post-operation 1, 2, 3 months (T1, T2, T3) from 25 November in 2015 to 21 June in 2016. A set of structured questionnaire was used to collect data including the demographic and clinical characteristic, the Symptom Severity Scale (SSS) and the Fatigue Symptom Inventory (FSI). Besides, patients were received the test of physical fitness including the body composition, the strength of hand grip and 30-second sit-to-stand test (STS-30). The descriptive statistics was used to analyze the each variable and the correlation statistics was used to explore the independent variable in the physical fitness. Lastly, the generalized estimating equations (GEE) was used to analyze cachexia and the change of physical fitness during operation. Totally, 46 patients completed this survey and the attribution rate was 6.5% during the period of data collecting. The results had shown that (1) the prevalence of cachexia was 44.1% and the group of cachexia had more DM than the group without cachexia; (2) the flatulence was the most severity symptom before operation and the early satiety was the most severity symptom within three months of post operation. Moreover, the fatigue was ranking second or third, which belonged to mild to moderate fatigue during three months after operation. However, the overall severity of symptom was significant lower in the second and third month of post-operation (T2, T3) than pre-operation (T0); (3) the body weight and the fat mass were significant decrease within three months after operation. Besides, the significant factors of physical fitness before surgery included gender, age, KPS, hemoglobin, albumin and implanting the bile stent before surgery, and (4) Even though cachexia was not independent factor in the physical fitness within three months after operation, the male decreased in the body weight, the skeletal muscle mass and the strength of hand grip more than the female. Besides, the population of the male with higher level of hemoglobin and albumin and the population of the female with younger and higher KPS’s scoring had better physical fitness performance during the recovery of operation. Cachexia is high prevalence among patients undergoing pancreatic surgery and these patients had worst level of physical fitness than the healthy people. The patients still significant lower in body weight and the fat mass within three months after surgery. Therefore, the health providers should put more attention to the population of the male on the change of physical fitness especially those were lower level of hemoglobin and albumin. These patients were received appropriate interventions to gain more nutritional supplement, maintain physical fitness and decrease the loss of body weight. Those multiple interventions lead to rebuild and promote the physical fitness after operation.