Valoración global subjetiva en pacientes oncológicos que serán sometidos a intervención quirúrgica, protocolo de manejo
Fecha
2016
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Universidad de Guayaquil. Facultad de Ciencias Médicas. Escuela de Graduados
Resumen
La enfermedad oncológica es la segunda causa de muerte en el mundo y su prevalencia aumenta en los últimos años. El paciente con enfermedad neoplásica tiene un riesgo elevado de malnutrición, por presentar alteraciones metabólicas complejas, por la enfermedad de base y por los tratamientos aplicados, siendo un problema no reconocido e infravalorado. Todos los pacientes que serán sometidos a cirugía electiva deben ser valorados nutricionalmente, no solo para diagnosticar los casos de malnutrición, sino también para detectar aquellos pacientes con mayor riesgo de padecerla, debido a la estrecha relación entre desnutrición y morbimortalidad postoperatoria. La valoración global subjetiva es una prueba sensible, específica y sencilla para la valoración nutricional del paciente oncológico. Este estudio de caso tiene como objetivo establecer los factores determinantes del estado nutricional de los pacientes y detectar a tiempo algún grado de afectación previa intervención quirúrgica. La metodología utilizada fue cualitativa, la modalidad de la investigación documental – bibliográfica, las categorías: educativa, socio-económica y médica; se lo realizó en el primer piso de cirugía de Hospital de Solca, con pacientes con distintos tipos de cáncer sometidos a intervención quirúrgica. Los resultados fueron: de acuerdo al IMC dos tercios de pacientes moderadamente mal nutrido, más de la mitad varones, neoplasia predominante gastrointestinal y la tercera parte de pacientes mal nutridos presentó complicaciones y mayor estancia hospitalaria. Pudiendo concluir que si los pacientes reciben soporte nutricional oportuno, mejora su respuesta metabólica, disminuye la aparición de estados mórbidos, estancia hospitalaria y mejora la calidad de vida de los pacientes.
The oncological disease is the second leading cause of death in the world and its prevalence increases in recent years. The patient with neoplastic disease has a high risk of malnutrition, by presenting complex metabolic alterations, by the underlying disease and by the applied treatments, remains a problem not recognized and undervalued. All patients who will undergo elective surgery should be valued nutritionally, not only to diagnose cases of malnutrition, but also to detect those patients with higher risk, due to the close relationship between malnutrition and postoperative morbimortality. The Subjective global assessment is a sensitive test, specific and simple for the nutritional assessment of oncologic patients. This case study has as objective to establish the determinants of the nutritional status of the patients and to detect some degree of affectation after surgical intervention. The methodology used was qualitative, the modality of the documentary research - bibliographical, categories: education, socioeconomic and medical; it is carried out on the first floor of surgery at the Hospital de Solca, with patients with different types of cancer undergoing surgical intervention. The results were: according to BMI two thirds of patients moderately malnourished, more than half men, predominant neoplasm gastrointestinal and the third part of malnourished patients presented complications and increased hospital stay. Being able to conclude that if the patients receive appropriate nutritional support improves its metabolic response, decreases the emergence of morbid states, hospital stay and improving the quality of life of the patients.
The oncological disease is the second leading cause of death in the world and its prevalence increases in recent years. The patient with neoplastic disease has a high risk of malnutrition, by presenting complex metabolic alterations, by the underlying disease and by the applied treatments, remains a problem not recognized and undervalued. All patients who will undergo elective surgery should be valued nutritionally, not only to diagnose cases of malnutrition, but also to detect those patients with higher risk, due to the close relationship between malnutrition and postoperative morbimortality. The Subjective global assessment is a sensitive test, specific and simple for the nutritional assessment of oncologic patients. This case study has as objective to establish the determinants of the nutritional status of the patients and to detect some degree of affectation after surgical intervention. The methodology used was qualitative, the modality of the documentary research - bibliographical, categories: education, socioeconomic and medical; it is carried out on the first floor of surgery at the Hospital de Solca, with patients with different types of cancer undergoing surgical intervention. The results were: according to BMI two thirds of patients moderately malnourished, more than half men, predominant neoplasm gastrointestinal and the third part of malnourished patients presented complications and increased hospital stay. Being able to conclude that if the patients receive appropriate nutritional support improves its metabolic response, decreases the emergence of morbid states, hospital stay and improving the quality of life of the patients.
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Neoplasias, Estado nutricional, Desnutrición, Protocolos, Hospital SOLCA de Guayaquil, Ecuador