中华胃肠外科杂志
中華胃腸外科雜誌
중화위장외과잡지
CHINESE JOURNAL OF GASTROINTESTINAL SURGERY
2011年
4期
271-274
,共4页
吴黎敏%周凤如%林庆凡%李航%李黎洪
吳黎敏%週鳳如%林慶凡%李航%李黎洪
오려민%주봉여%림경범%리항%리려홍
结直肠肿瘤%营养风险评估%术后并发症%死亡率
結直腸腫瘤%營養風險評估%術後併髮癥%死亡率
결직장종류%영양풍험평고%술후병발증%사망솔
Colorectal neoplasms%Nutritional risk screening%Postoperative complications%Morality rate
目的 探讨营养风险筛查对结直肠癌手术死亡率和并发症发生率的预测价值.方法 前瞻性将2006年1月至2009年12月间福建省莆田学院附属医院行择期开腹手术的289例结直肠癌患者.分别按照Reilly营养风险评分(Reilly NRS)和欧洲临床营养与代谢协会的营养风险评分(NRS-2002)进行营养风险筛查.结果 289例患者围手术期死亡率为3.5%(10/289),术后并发症发生率为29.4%(82/279).按Reilly NRS评分,营养风险组(≥4分,89例)和无营养风险组(＜4分,200例)的围手术期死亡率分别为5.6%(5/89)和2.5%(5/200)(P＞0.05);术后并发症发生率分别为36.1%(31/83)和26.5%(51/196)(P＞0.05).按NRS-2002评分,营养风险组(≥3分,105例)和无营养风险组(＜3分,184例)的围手术期死亡率分别为5.7%(6/105)和2.2%(4/184)(P＞0.05);术后并发症发生率分别为38.4%(38/99)和24.4%(44/180)(P＜0.05).经多因素逻辑回归分析证实,NRS-2002评分是结直肠癌手术后并发症的独立危险因素(P=0.007,OR=3.14,95%CI:1.63～6.29).结论 NRS-2002评分作为一种术前营养风险筛查方法,可有效预测结直肠癌手术后并发症的发生率.
目的 探討營養風險篩查對結直腸癌手術死亡率和併髮癥髮生率的預測價值.方法 前瞻性將2006年1月至2009年12月間福建省莆田學院附屬醫院行擇期開腹手術的289例結直腸癌患者.分彆按照Reilly營養風險評分(Reilly NRS)和歐洲臨床營養與代謝協會的營養風險評分(NRS-2002)進行營養風險篩查.結果 289例患者圍手術期死亡率為3.5%(10/289),術後併髮癥髮生率為29.4%(82/279).按Reilly NRS評分,營養風險組(≥4分,89例)和無營養風險組(＜4分,200例)的圍手術期死亡率分彆為5.6%(5/89)和2.5%(5/200)(P＞0.05);術後併髮癥髮生率分彆為36.1%(31/83)和26.5%(51/196)(P＞0.05).按NRS-2002評分,營養風險組(≥3分,105例)和無營養風險組(＜3分,184例)的圍手術期死亡率分彆為5.7%(6/105)和2.2%(4/184)(P＞0.05);術後併髮癥髮生率分彆為38.4%(38/99)和24.4%(44/180)(P＜0.05).經多因素邏輯迴歸分析證實,NRS-2002評分是結直腸癌手術後併髮癥的獨立危險因素(P=0.007,OR=3.14,95%CI:1.63～6.29).結論 NRS-2002評分作為一種術前營養風險篩查方法,可有效預測結直腸癌手術後併髮癥的髮生率.
목적 탐토영양풍험사사대결직장암수술사망솔화병발증발생솔적예측개치.방법 전첨성장2006년1월지2009년12월간복건성보전학원부속의원행택기개복수술적289례결직장암환자.분별안조Reilly영양풍험평분(Reilly NRS)화구주림상영양여대사협회적영양풍험평분(NRS-2002)진행영양풍험사사.결과 289례환자위수술기사망솔위3.5%(10/289),술후병발증발생솔위29.4%(82/279).안Reilly NRS평분,영양풍험조(≥4분,89례)화무영양풍험조(＜4분,200례)적위수술기사망솔분별위5.6%(5/89)화2.5%(5/200)(P＞0.05);술후병발증발생솔분별위36.1%(31/83)화26.5%(51/196)(P＞0.05).안NRS-2002평분,영양풍험조(≥3분,105례)화무영양풍험조(＜3분,184례)적위수술기사망솔분별위5.7%(6/105)화2.2%(4/184)(P＞0.05);술후병발증발생솔분별위38.4%(38/99)화24.4%(44/180)(P＜0.05).경다인소라집회귀분석증실,NRS-2002평분시결직장암수술후병발증적독립위험인소(P=0.007,OR=3.14,95%CI:1.63～6.29).결론 NRS-2002평분작위일충술전영양풍험사사방법,가유효예측결직장암수술후병발증적발생솔.
Objective To evaluate the impact of nutritional status on postoperative outcomes for patients with colorectal cancer. Methods Data of 289 colorectal cancer patients from the Affiliated Hospital of Putian Medical College between January 2006 and December 2009 were collected prospectively. Nutritional status was evaluated according to Reilly Nutrition Risk Score(Reilly NRS)and Nutrition Risk Screening 2002(NRS-2002). Results The postoperative mortality was 3.5%(10/289)and the complication rate was 29.4%(82/297). Patients were stratified into those at nutrition risk (n=89) and those not at risk (n=200) according to Reilly NRS and the two groups were similar in mortality rate (5.6% vs. 2.5%, P＞0.05) and complication rate (36.1% vs. 26.5%, P＞0.05). When stratified using NRS-2002, patients at nutritional risk(n=105) had a similar mortality rate (5.7% vs.2.2%, P＞0.05) but a higher complication rate (38.4% vs. 24.4%, P＜0.05). NRS-2002 remained as an significant predictor of postoperative complications (P=0.007, OR=3.14, 95% CI: 1.63-6.29) on multivariable logistic regression analysis. Conclusion As a nutritional evaluation tool, NRS-2002 may predict postoperative comphcation for colorectal cancer.
