本文選題：結(jié)直腸癌 + 營養(yǎng)風(fēng)險(xiǎn)��； 參考：《大連醫(yī)科大學(xué)》2017年碩士論文

【摘要】：背景:結(jié)直腸癌屬于全世界范圍內(nèi)比較常見的一種惡性腫瘤,而且隨著近年來我國社會(huì)的發(fā)展進(jìn)步,結(jié)直腸癌在我國的發(fā)病率及死亡率在不斷增長。對(duì)于發(fā)病率及死亡率都日益增長的結(jié)直腸癌來說,手術(shù)切除是最主要的治療方式。許多研究證明術(shù)前患者營養(yǎng)狀況往往會(huì)影響到患者術(shù)后恢復(fù)情況,而結(jié)直腸癌患者入院前,其中相當(dāng)一部分的患者處于不同程度的營養(yǎng)不良的狀態(tài),需要對(duì)其營養(yǎng)狀態(tài)進(jìn)行改善。目的:分析術(shù)前營養(yǎng)狀況與結(jié)直腸癌手術(shù)患者臨床結(jié)局的相關(guān)性。方法:對(duì)山東省青島市市立醫(yī)院東院區(qū)普外二病區(qū)單一醫(yī)療組在2014年9月至2016年9月期間,限期行結(jié)直腸癌根治術(shù)的146例結(jié)直腸癌患者進(jìn)行回顧性系統(tǒng)調(diào)查研究。運(yùn)用NRS 2002對(duì)患者術(shù)前的營養(yǎng)狀況進(jìn)行營養(yǎng)風(fēng)險(xiǎn)評(píng)估篩查,分析結(jié)直腸癌患者術(shù)前營養(yǎng)狀況與術(shù)后臨床結(jié)局的相關(guān)性的聯(lián)系。按照NRS 2002標(biāo)準(zhǔn)對(duì)患者術(shù)前營養(yǎng)狀況進(jìn)行營養(yǎng)風(fēng)險(xiǎn)評(píng)估分組(A組具有營養(yǎng)風(fēng)險(xiǎn)組;B組無營養(yǎng)風(fēng)險(xiǎn)組).結(jié)果:根據(jù)NRS 2002評(píng)分,有64例(43.84%)患者無營養(yǎng)風(fēng)險(xiǎn)(NRS 2002評(píng)分3分),有82例(56.16%)患者具有營養(yǎng)風(fēng)險(xiǎn)(NRS 2002評(píng)分≥3分)。入組患者中年齡分組:年齡≥70歲的40例,年齡70歲的106例;合并癥分組:合并腸梗阻的有17例;術(shù)前血紅蛋白(男120g/L女110g/L)的23例;術(shù)前血清白蛋白35g/L的14例。其中年齡≥70歲(P0.001)、合并腸梗阻(P=0.021,P0.05)、血紅蛋白(男120g/L 女110g/L)(P=0.02,P0.05)、血清白蛋白35g/L(P=0.004,P0.05)屬于影響營養(yǎng)狀況的相關(guān)性因素,P0.05具有統(tǒng)計(jì)學(xué)意義。術(shù)前具有營養(yǎng)風(fēng)險(xiǎn)(NRS 2002≥3分)的結(jié)直腸癌患者組術(shù)后發(fā)生并發(fā)癥的人數(shù)占入選營養(yǎng)風(fēng)險(xiǎn)組患者總?cè)藬?shù)的28.05%;術(shù)前無營養(yǎng)風(fēng)險(xiǎn)(NRS 20023分)的結(jié)直腸癌患者組術(shù)后發(fā)生并發(fā)癥的人數(shù)占入選無營養(yǎng)風(fēng)險(xiǎn)組患者總?cè)藬?shù)的12.5%。相比較于營養(yǎng)風(fēng)險(xiǎn)組,無營養(yǎng)風(fēng)險(xiǎn)組術(shù)后并發(fā)癥發(fā)生率相對(duì)更低,且差距有統(tǒng)計(jì)學(xué)意義(P=0.002,P0.05)。而且營養(yǎng)風(fēng)險(xiǎn)組患者的住院時(shí)間明顯多于無營養(yǎng)風(fēng)險(xiǎn)組的住院時(shí)間,且t=2.416,p= 0.02,p0.05,有統(tǒng)計(jì)學(xué)意義。營養(yǎng)風(fēng)險(xiǎn)組的肛門排氣時(shí)間明顯多于無營養(yǎng)風(fēng)險(xiǎn)組的肛門排氣時(shí)間,且t=3.033,p= 0.04,p0.05,有統(tǒng)計(jì)學(xué)意義。結(jié)論:在結(jié)直腸癌患者中,術(shù)前合并腸梗阻、年齡≥70歲、術(shù)前血紅蛋白(男120g/L女110g/L)、術(shù)前血清白蛋白35g/L的這一類結(jié)直腸癌患者更容易出現(xiàn)營養(yǎng)風(fēng)險(xiǎn);具有營養(yǎng)風(fēng)險(xiǎn)(NRS 2002評(píng)分≥3分)的結(jié)直腸癌患者組術(shù)后更容易出現(xiàn)并發(fā)癥且出院時(shí)間及肛門排氣時(shí)間都會(huì)相對(duì)延長,因此對(duì)于具有營養(yǎng)風(fēng)險(xiǎn)(NRS 2002評(píng)分≥3分)的結(jié)直腸癌患者需要改善其術(shù)前的營養(yǎng)狀況,以減少不良的臨床結(jié)局的發(fā)生。
[Abstract]:Background: colorectal cancer is one of the most common malignant tumors in the world. With the development of our society in recent years, the morbidity and mortality of colorectal cancer in China are increasing. Surgical resection is the most important treatment for colorectal cancer, where morbidity and mortality are increasing. Many studies have shown that preoperative nutritional status often affects postoperative recovery, whereas before admission to hospital for colorectal cancer, a significant proportion of these patients are in varying degrees of malnutrition. Their nutritional status needs to be improved. Objective: to analyze the relationship between preoperative nutritional status and clinical outcome of colorectal cancer patients. Methods: from September 2014 to September 2016, 146 patients with colorectal cancer underwent radical resection of colorectal cancer were studied retrospectively. NRS 2002 was used to screen the nutritional risk of the patients before operation and to analyze the relationship between preoperative nutritional status and postoperative clinical outcome in patients with colorectal cancer. According to NRS 2002 standard, the nutritional risk assessment of patients before operation was carried out in group A with nutritional risk group and group B with no nutritional risk group. Results: according to the NRS 2002 score, there were 64 patients with no nutritional risk and 32 patients with NRS 2002 score (3 points) and 82 patients with nutritional risk (NRS 2002 score 鈮，

本文編號(hào)：1820854