本文選題：胃腫瘤 + 營(yíng)養(yǎng)風(fēng)險(xiǎn)篩查��； 參考：《腸外與腸內(nèi)營(yíng)養(yǎng)》2017年03期

【摘要】：目的:探討胃癌病人術(shù)前存在營(yíng)養(yǎng)風(fēng)險(xiǎn)對(duì)術(shù)后臨床結(jié)局的影響以及預(yù)后不良的危險(xiǎn)因素分析。方法:前瞻性觀察140例胃癌病人,術(shù)前進(jìn)行NRS 2002營(yíng)養(yǎng)風(fēng)險(xiǎn)篩查,分析術(shù)前存在營(yíng)養(yǎng)風(fēng)險(xiǎn)對(duì)術(shù)后并發(fā)癥、住院時(shí)間、入住ICU時(shí)間、住院費(fèi)用、60 d再入院及病死率的影響。運(yùn)用單因素和多因素分析研究圍手術(shù)期并發(fā)癥的危險(xiǎn)因素。結(jié)果:NRS 2002≥3分與NRS 20023分的病人總并發(fā)癥發(fā)生率、肺部感染發(fā)生率、總住院天數(shù)和術(shù)后住院天數(shù)均有顯著性差異(P0.05);而吻合口瘺、胸腔積液發(fā)生率、60 d再入院率、60 d病死率和住院費(fèi)用等方面,雖然有營(yíng)養(yǎng)風(fēng)險(xiǎn)組略高于無(wú)營(yíng)養(yǎng)風(fēng)險(xiǎn)組,但無(wú)統(tǒng)計(jì)學(xué)差異(P0.05)。單因素和多因素分析顯示,術(shù)前高總膽固醇水平和術(shù)前存在營(yíng)養(yǎng)風(fēng)險(xiǎn)是影響病人預(yù)后的危險(xiǎn)因素,也是發(fā)生術(shù)后并發(fā)癥的獨(dú)立危險(xiǎn)因素。結(jié)論:術(shù)前存在營(yíng)養(yǎng)風(fēng)險(xiǎn)病人的臨床結(jié)局明顯差于無(wú)營(yíng)養(yǎng)風(fēng)險(xiǎn)病人,術(shù)前高總膽固醇水平和存在營(yíng)養(yǎng)風(fēng)險(xiǎn)是圍手術(shù)期并發(fā)癥的獨(dú)立危險(xiǎn)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.
【作者單位】： 第四軍醫(yī)大學(xué)附屬西京醫(yī)院消化外科;
【基金】：衛(wèi)計(jì)委公益性行業(yè)科研專(zhuān)項(xiàng)資助(201502022)
【分類(lèi)號(hào)】：R459.3;R735.2

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