CAJ | 학술논문

目的探讨营养风险筛查2002(NRS2002)和营养不良通用筛查工具(MUST)对胃癌患者进行术前营养风险评分的临床价值.方法对2004年1月至2007年12月中山大学附属第三医院收治的314例需行手术治疗的胃癌患者,应用主观全面评定(SGA)、NRS2002和MUST评分系统评估术前营养风险,观察其对术后并发症、住院时间的影响.采用Wilcoxon检验、Kappa检验和Logistics回归方程分析数据.结果以SGA为对照,NRS2002的敏感度为86.7%,特异度为74.2%,阳性预测值为86.9%,阴性预测值为73.8%;而MUST的敏感度为73.1%,特异度为70.6%,阳性预测值为74.8%,阴性预测值为68.7%.MUST与SGA评分比较K=0.436,NRS2002与SGA评分的结果比较K=0.601,NRS2002和SGA具有更高的一致性.MUST和NRS2002的评分越高预示患者将有更长的住院时间及更高的并发症发生率,MUST的相对危险度分别为2.517和0.529,低于NRS2002的3.426和0.642.结论 MUST及NRS2002均适合胃癌患者的术前营养风险评估,评分越高预示更多的术后并发症及更长的住院时间,而NRS2002较MUST能更准确的反映胃癌患者营养风险的状况.
목적 탐토영양풍험사사2002(NRS2002)화영양불량통용사사공구(MUST)대위암환자진행술전영양풍험평분적림상개치.방법 대2004년1월지2007년12월중산대학부속제삼의원수치적314례수행수술치료적위암환자,응용주관전면평정(SGA)、NRS2002화MUST평분계통평고술전영양풍험,관찰기대술후병발증、주원시간적영향.채용Wilcoxon검험、Kappa검험화Logistics회귀방정분석수거.결과 이SGA위대조,NRS2002적민감도위86.7%,특이도위74.2%,양성예측치위86.9%,음성예측치위73.8%;이MUST적민감도위73.1%,특이도위70.6%,양성예측치위74.8%,음성예측치위68.7%.MUST여SGA평분비교K=0.436,NRS2002여SGA평분적결과비교K=0.601,NRS2002화SGA구유경고적일치성.MUST화NRS2002적평분월고예시환자장유경장적주원시간급경고적병발증발생솔,MUST적상대위험도분별위2.517화0.529,저우NRS2002적3.426화0.642.결론 MUST급NRS2002균괄합위암환자적술전영양풍험평고,평분월고예시경다적술후병발증급경장적주원시간,이NRS2002교MUST능경준학적반영위암환자영양풍험적상황.
Objective To investigate the clinical value of nutritional risk screening 2002(NRS2002)and malnutritional universal screening tools(MUST)in the preoperative nutrition risk evaluation of patients with gastric cancer.Methods The preoperative nutritional risk of 3 14 patients who had been admitted to the Third Affiliated Hospital of Sun Yat-sen University from January 2004 to December 2007 was assessed by subjective global assessment(SGA),NRS 2002 and M UST,and the influence of nutritional risk on the incidence of postoperative complications and hospital stay was investigated.All data were analyzed by Wilcoxon test,Kappa test and Logistics regression analysis.Results Compared with SGA,the sensitivity,specificity,positive predicting value and negative predicting value were 86.7%,74.2%,86.9% and 73.8% for NRS2002,and were 73.1%,70.6%,74.8% and 68.7% for MUST.Compared with MUST,NRS2002 had a higher consistency with SGA(K_(NRS2002)=0.601,K_(MUST)=0.436).Logistic regression analysis revealed that patients with higher MUST or NRS2002 score had higher incidence of postoperative complications and longer hospital stay.In the aspect of hospital stay,the relative risk of MUST was 2.517,which was lower than 3.426 of NRS2002.The relative risk of MUST was 0.529,which was lower than 0.642 of NRS2002 in the aspect of incidence of postoperative complications.Conclusions NRS2002 and MUST are suitable for preoperative nutritional risk screening of patients with gastric cancer,and the score of NRS2002 or MUST is associated with the incidence of postoperative complications and length of hospital stay.However,NRS2002 is more accurate than MUST in the reflection of nutritional risk of patients with gastric cancer.