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Head and neck tumors are a significant group of malignant neoplasms. Dysphagia is one of the most important problems in the nutrition of patients with tumors of the oral cavity and oropharynx. It is present in almost every patient and accounts for 90-95% of cases, both in the preoperative and postoperative period. Problems with swallowing in head and neck cancer may be related, first of all, to the type and size of the tumor itself, which disrupts the ability to eat. Disturbance in the pushing of the food lump develops as a result of dysfunction of the affected muscles or damage to peripheral nerves. There are also early and late disturbances of normal swallowing after radiation and chemotherapy for malignant tumors of the oral cavity, oropharynx, and larynx. Such patients already have a nutritional deficiency in the preoperative period. The purpose of the study was to assess the frequency of nutritional insufficiency in patients with oncology of the oral cavity and oropharynx in the preoperative period and to identify the most significant criteria for nutritional status violations. Materials and methods. The study was conducted in 41 patients, aged 38-55 years (35 men, 6 women) with stage I-III of malignant tumors of the lips, tongue, floor of the mouth and oropharynx. We determined the dynamics of weight in cancer patients with pathology of the oral cavity and oropharynx from the onset of the disease and at the stages of treatment. The patient was weighed at the time of hospitalization and in the postoperative period for 3, 5, 7, 9, 12 days. Anamnestically, weight was determined 3-6 months after the first signs of the disease. Body mass index, shoulder circumference and thickness of the skin-fatty fold of the triceps were measured and calculated, as well as laboratory indicators – biochemical markers: total protein, albumin, transferrin, absolute number of lymphocytes. Results and discussion. The patient's weight loss before the first signs of the disease averaged 6-8 kg. In the postoperative period, a gradual weight loss was noted until the ninth day after the operation, and then weight stabilization was observed. In nine days, patients lost 4-7 kg of weight from the time of hospitalization. The fastest weight loss was observed in the period of 3-7 days of the postoperative period. The average values of anthropometric indicators in the studied group, with the exception of a moderate decrease in the size of the skin-fatty fold in men, were within the normal range. A decrease in the absolute number of lymphocytes, less than 1.5 thousand in 1 μl (p <0.05), was noted in 71% (29/41). Indicators characterizing the visceral protein pool (total protein, transferrin) were also within normal values, except for albumin, which was slightly reduced in 63%. Conclusion. A comprehensive study revealed in the preoperative period in patients with oncopathology of the oral cavity and oropharynx a high incidence of malnutrition (85%). The main contribution to the change of trophological status is a decrease in the cellular component of immunity and albumin
Head and neck tumors are a significant group of malignant neoplasms. Dysphagia is one of the most important problems in the nutrition of patients with tumors of the oral cavity and oropharynx. It is present in almost every patient and accounts for 90-95% of cases, both in the preoperative and postoperative period. Problems with swallowing in head and neck cancer may be related, first of all, to the type and size of the tumor itself, which disrupts the ability to eat. Disturbance in the pushing of the food lump develops as a result of dysfunction of the affected muscles or damage to peripheral nerves. There are also early and late disturbances of normal swallowing after radiation and chemotherapy for malignant tumors of the oral cavity, oropharynx, and larynx. Such patients already have a nutritional deficiency in the preoperative period. The purpose of the study was to assess the frequency of nutritional insufficiency in patients with oncology of the oral cavity and oropharynx in the preoperative period and to identify the most significant criteria for nutritional status violations. Materials and methods. The study was conducted in 41 patients, aged 38-55 years (35 men, 6 women) with stage I-III of malignant tumors of the lips, tongue, floor of the mouth and oropharynx. We determined the dynamics of weight in cancer patients with pathology of the oral cavity and oropharynx from the onset of the disease and at the stages of treatment. The patient was weighed at the time of hospitalization and in the postoperative period for 3, 5, 7, 9, 12 days. Anamnestically, weight was determined 3-6 months after the first signs of the disease. Body mass index, shoulder circumference and thickness of the skin-fatty fold of the triceps were measured and calculated, as well as laboratory indicators – biochemical markers: total protein, albumin, transferrin, absolute number of lymphocytes. Results and discussion. The patient's weight loss before the first signs of the disease averaged 6-8 kg. In the postoperative period, a gradual weight loss was noted until the ninth day after the operation, and then weight stabilization was observed. In nine days, patients lost 4-7 kg of weight from the time of hospitalization. The fastest weight loss was observed in the period of 3-7 days of the postoperative period. The average values of anthropometric indicators in the studied group, with the exception of a moderate decrease in the size of the skin-fatty fold in men, were within the normal range. A decrease in the absolute number of lymphocytes, less than 1.5 thousand in 1 μl (p <0.05), was noted in 71% (29/41). Indicators characterizing the visceral protein pool (total protein, transferrin) were also within normal values, except for albumin, which was slightly reduced in 63%. Conclusion. A comprehensive study revealed in the preoperative period in patients with oncopathology of the oral cavity and oropharynx a high incidence of malnutrition (85%). The main contribution to the change of trophological status is a decrease in the cellular component of immunity and albumin
Tumors of the mouth and oropharynx are a significant group of malignant neoplasms characterized by a progressive increase in morbidity. Almost every patient has dysphagia and accounts for 90-95 % of cases. Problems with swallowing in head and neck cancer may be associated primarily with the type and size of the tumor itself, which impairs the ability to eat. Therefore, the question of the presence of malnutrition in patients with oral and oropharyngeal cancer in the preoperative period and methods for detecting nutritional insufficiency remains open significant criteria for nutritional status violation. The aim of our study was to evaluate the frequency of nutritional insufficiency in patients with oncopathology of the oral cavity and oropharynx in the preoperative period and to identify the most significant criteria for nutritional status disorders. The results of nutritional status assessment of 46 patients with oncopathology of the oral cavity and oral pharynx in the preoperative period were analyzed. Somatometric (body mass index, shoulder circumference, skin-fat clot thickness) and laboratory (total blood protein, albumin, transfers, absolute lymphocyte count) methods were used. Mean values were reduced only for albumin and the absolute number of lymphocytes. Anthropometric indicators in the study group, with the exception of a moderate decrease in the size of the skin and fat folds in men, were within normal limits. Analyzing the data obtained, it was found that 85 % (39 patients) of patients were malnourished. In 32 patients the disorders were mild, in 6 – moderate and one had severe malnutrition. When assessing the trophological status, it was found that one indicator was reduced in 35 % (16/46), two – in 28 % (13/46), three – in 31 % (14/46), four – in 4 % (2/46), five – in 2 % (1/46). Malnutrition was detected by assessing the absolute number of lymphocytes in 71 % and blood albumin in 63 %, the thickness of the skin and fat clot in 50 %. BMI assessment revealed grade I malnutrition in 7 patients, while malnutrition was detected in 85 %. Thus, comprehensive study revealed in the preoperative period in patients with oncopathology of the oral and oropharynx a high incidence of malnutrition (85 %). The main contribution to the change of trophological status is a decrease in the cellular component of immunity and albumin.
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