Suporte nutricional enteral : um adjuvante terapeutico em cancer de cabeça e pescoço

AUTOR(ES)
DATA DE PUBLICAÇÃO

1994

RESUMO

Malnutrition is very common in hospitalized surgical cancer patient and envolves immune and organic response of the host in all modality of antineoplasic therapy, increasing the morbimortalifcy and septics complications and the permanence of the patient at hospital. The nutritional reserve of the host is necessary for adequate function and for improving the immune response for the sucessfull antineoplasic treatment in these complex cases. These factors bring great benefice in complex cases, because wound healing and immune response are adjuvant in cancer surgical recovery. The main objective of this study was to evaluate the nutritional effect of using an enteric feeding tube and assessment the nutritional status by global, clinics, subjectives and biochemical methods in advanced head and neck cancer patient. Besides, establishing an adequate nutritional therapy and dietary immunomodulation, changing this serious situation of malnutrition and decreasing the incidence of postoperative septic complications. Twenty eight advanced head and neck cancer patient were submitted to the global nutritional assessment (GNA) and nutritional support therapy. They were prospectively, monitorized and the following measurements were performed: % recent weight loss (%LW), mid-circunference arm (CMA), mid~circunference muscular arm (MCMA), triceps skinfold thickness (TST), serum albumin (SA) , serum total protein (STP) , serum limphocitometry (SL), serum transferin (ST), nitrogen balance (NB), creatinine height index (ICH) and rate energy expenditure (REE). This study was showed by GNA an elevation of the malnutrition index of 75% and different types of malnutrition. The GNA revealed a good method for diagnose of nutritional disorders. Enteric feeding tube improved significantly the clinic parameters (p<0,05) and by improving recent weight loss %(LW), serum limphocitometry (SL) and nitrogen balance (NB). The absolute values were improved for all clinic parameters, but without statistically significance. The total enteral nutrition (TEH) attended a single nutritional requirement and Recommended Dietary Allowances (*RDA) for all patients. The conclusions were: The specific nutritional therapy and nutritional assessment by global and subjective evaluation were of great benefit for recoverine the clinic and nutritional protein defficiency. They improved the outcome of the head and neck, cancer patient and could reverse malnutrition. It is possible the recovering of the immune and organic response. The diet ary therapy and immunomodulation with enteric feeding tube could reduce septic complications and morfoimortality. Similarly it may help to reduced surgical cancer patient hospitalization and avoid the acquired immune nutritional defficiency (NAIDS), which normally worsen the patient situation. Additionally, the nutritional support is very important for the good outcome with nutritional, therapy and early nutritional diagnose. In summary, this research demostrated that enteric feeding tube can reverse malnutrition in advanced head and neck cancer patient. Probably, the enteral nutrition help to improve the raiune response favourably in all modality of antineoplasic treatment, mainly in oncologic surgical patient.

ASSUNTO(S)

dietoterapia cabeça - cancer - tratamento pescoço - cancer - tratamento alimentação enteral

Documentos Relacionados