胃癌病人术前有营养风险是临床预后不良的危险因素

发布时间：2018-06-05 04:20

本文选题：胃肿瘤 + 营养风险筛查　；参考：《肠外与肠内营养》2017年03期

【摘要】：目的:探讨胃癌病人术前存在营养风险对术后临床结局的影响以及预后不良的危险因素分析。方法:前瞻性观察140例胃癌病人,术前进行NRS 2002营养风险筛查,分析术前存在营养风险对术后并发症、住院时间、入住ICU时间、住院费用、60 d再入院及病死率的影响。运用单因素和多因素分析研究围手术期并发症的危险因素。结果:NRS 2002≥3分与NRS 20023分的病人总并发症发生率、肺部感染发生率、总住院天数和术后住院天数均有显著性差异(P0.05);而吻合口瘘、胸腔积液发生率、60 d再入院率、60 d病死率和住院费用等方面,虽然有营养风险组略高于无营养风险组,但无统计学差异(P0.05)。单因素和多因素分析显示,术前高总胆固醇水平和术前存在营养风险是影响病人预后的危险因素,也是发生术后并发症的独立危险因素。结论:术前存在营养风险病人的临床结局明显差于无营养风险病人,术前高总胆固醇水平和存在营养风险是围手术期并发症的独立危险因素。
[Abstract]:Objective: to investigate the effect of preoperative nutritional risk on postoperative outcome and risk factors of poor prognosis in patients with gastric cancer. Methods: NRS 2002 nutritional risk screening was performed in 140 patients with gastric cancer prospectively. The effects of nutritional risk on postoperative complications, hospitalization time, ICU stay time, hospitalization expenses and 60 days re admission and mortality were analyzed. Single factor and multi-factor analysis were used to study the risk factors of perioperative complications. Results there were significant differences in the incidence of complications, the incidence of pulmonary infection, the total hospital stay and the postoperative hospital stay between the patients with the score of 2002 or 3 and the score of NRS 2002.There was a significant difference between the two groups (P < 0.05), and the anastomotic leakage was found in the patients with anastomotic leakage. The incidence of pleural effusion, 60 d readmission rate, 60 d mortality and hospitalization expenses were slightly higher in the nutritional risk group than in the non nutritional risk group, but there was no significant difference between the two groups (P 0.05). Univariate and multivariate analysis showed that preoperative high total cholesterol level and preoperative nutritional risk were the risk factors affecting the prognosis of patients, but also an independent risk factor for postoperative complications. Conclusion: the clinical outcome of patients with nutritional risk before operation is significantly worse than that of patients without nutritional risk. High preoperative total cholesterol level and nutritional risk are independent risk factors for perioperative complications.
【作者单位】：第四军医大学附属西京医院消化外科;
【基金】：卫计委公益性行业科研专项资助(201502022)
【分类号】：R459.3;R735.2

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