中国医师进修杂志
中國醫師進脩雜誌
중국의사진수잡지
CHINESE JOURNAL OF POSTGRADUATES OF MEDICINE
2014年
5期
27-30
,共4页
肠肿瘤%营养不良%手术后并发症%营养风险筛查
腸腫瘤%營養不良%手術後併髮癥%營養風險篩查
장종류%영양불량%수술후병발증%영양풍험사사
Intestinal neoplasms%Malnutrition%Postoperative complications%Nutritional risk screening
目的 应用营养风险筛查2002(NRS2002)评分系统对大肠癌患者的术前营养风险进行评估,并观察患者的适用性及对患者术后结局的影响.方法 选择手术治疗的大肠癌患者259例,按照NRS2002评分标准进行术前营养风险评估,观察不同性别、年龄、肿瘤部位、病理分化情况及Dukes分期大肠癌患者的评分特点,及不同评分对术后并发症、围手术期病死率及住院时间的影响.结果 行NRS2002评分患者243例,NRS2002评分≥3分80例,＜3分163例.大肠癌患者性别、病理分化与术前NRS2002评分无关(P＞0.05),年龄、肿瘤部位、Dukes分期与术前NRS2002评分有关(P＜0.01).243例患者无一例围手术期死亡.住院时间10～ 101(21.6±9.7)d.≥3分患者的并发症发生率为30.0％(24/80),高于＜3分患者的17.2％ (28/163);≥3分患者住院时间(20.5±8.2)d,短于＜3分患者的(23.9±11.9)d,差异有统计学意义(P＜0.05).多元Logistic回归分析显示性别、年龄、肿瘤部位、病理分化情况、Dukes分期、手术方式与大肠癌术后并发症发生无关(P＞0.05),NRS2002评分与大肠癌术后并发症发生有关(P＜0.05).Pearson相关分析显示住院时间与NRS2002评分存在相关性(P＜0.01).结论 NRS2002评分适合于我国大肠癌患者的术前营养风险评估,且老年和青年、近端大肠、Dukes分期D期的大肠癌患者相比于中年、远端大肠及其他Dukes分期的患者更易存在术前营养风险.NRS2002评分≥3分的患者预示术后更易发生并发症和更长的住院时间,提示NRS2002评分≥3分的患者在术前需要加强营养支持.
目的 應用營養風險篩查2002(NRS2002)評分繫統對大腸癌患者的術前營養風險進行評估,併觀察患者的適用性及對患者術後結跼的影響.方法 選擇手術治療的大腸癌患者259例,按照NRS2002評分標準進行術前營養風險評估,觀察不同性彆、年齡、腫瘤部位、病理分化情況及Dukes分期大腸癌患者的評分特點,及不同評分對術後併髮癥、圍手術期病死率及住院時間的影響.結果 行NRS2002評分患者243例,NRS2002評分≥3分80例,＜3分163例.大腸癌患者性彆、病理分化與術前NRS2002評分無關(P＞0.05),年齡、腫瘤部位、Dukes分期與術前NRS2002評分有關(P＜0.01).243例患者無一例圍手術期死亡.住院時間10～ 101(21.6±9.7)d.≥3分患者的併髮癥髮生率為30.0％(24/80),高于＜3分患者的17.2％ (28/163);≥3分患者住院時間(20.5±8.2)d,短于＜3分患者的(23.9±11.9)d,差異有統計學意義(P＜0.05).多元Logistic迴歸分析顯示性彆、年齡、腫瘤部位、病理分化情況、Dukes分期、手術方式與大腸癌術後併髮癥髮生無關(P＞0.05),NRS2002評分與大腸癌術後併髮癥髮生有關(P＜0.05).Pearson相關分析顯示住院時間與NRS2002評分存在相關性(P＜0.01).結論 NRS2002評分適閤于我國大腸癌患者的術前營養風險評估,且老年和青年、近耑大腸、Dukes分期D期的大腸癌患者相比于中年、遠耑大腸及其他Dukes分期的患者更易存在術前營養風險.NRS2002評分≥3分的患者預示術後更易髮生併髮癥和更長的住院時間,提示NRS2002評分≥3分的患者在術前需要加彊營養支持.
목적 응용영양풍험사사2002(NRS2002)평분계통대대장암환자적술전영양풍험진행평고,병관찰환자적괄용성급대환자술후결국적영향.방법 선택수술치료적대장암환자259례,안조NRS2002평분표준진행술전영양풍험평고,관찰불동성별、년령、종류부위、병리분화정황급Dukes분기대장암환자적평분특점,급불동평분대술후병발증、위수술기병사솔급주원시간적영향.결과 행NRS2002평분환자243례,NRS2002평분≥3분80례,＜3분163례.대장암환자성별、병리분화여술전NRS2002평분무관(P＞0.05),년령、종류부위、Dukes분기여술전NRS2002평분유관(P＜0.01).243례환자무일례위수술기사망.주원시간10～ 101(21.6±9.7)d.≥3분환자적병발증발생솔위30.0％(24/80),고우＜3분환자적17.2％ (28/163);≥3분환자주원시간(20.5±8.2)d,단우＜3분환자적(23.9±11.9)d,차이유통계학의의(P＜0.05).다원Logistic회귀분석현시성별、년령、종류부위、병리분화정황、Dukes분기、수술방식여대장암술후병발증발생무관(P＞0.05),NRS2002평분여대장암술후병발증발생유관(P＜0.05).Pearson상관분석현시주원시간여NRS2002평분존재상관성(P＜0.01).결론 NRS2002평분괄합우아국대장암환자적술전영양풍험평고,차노년화청년、근단대장、Dukes분기D기적대장암환자상비우중년、원단대장급기타Dukes분기적환자경역존재술전영양풍험.NRS2002평분≥3분적환자예시술후경역발생병발증화경장적주원시간,제시NRS2002평분≥3분적환자재술전수요가강영양지지.
Objective To evaluate the preoperative nutritional status of patients with colorectal carcinoma by using the nutritional risk screening 2002 (NRS2002) score and its prediction for postoperative outcomes.Methods Retrospectively evaluated the nutritional risk of 259 colorectal cancer patients with NRS2002 score in terms of different sexes,ages,tumor location,pathology and differentiation,Dukes stages.The relationship between different NRS2002 score and postoperative complications and hospital stay were also observed.Results NRS2002 score was applicable in 243 cases,≥ 3 scores of 80 cases,＜ 3 scores of 163 cases.Gender,histological differentiation and before surgery NRS2002 score unrelated (P ＞ 0.05).Ages,tumor location,and Dukes stages related NRS2002 score (P ＜ 0.01).No case of perioperative death,hospital stay 10-101 (21.6 ± 9.7) d.The incidence of complications in ≥ 3 scores patients was significantly higher than that in ＜ 3 scores patients [30.0％ (24/80) vs.17.2 ％ (28/163),P ＜ 0.05],hospital stay in ≥ 3 scores patients was significantly shorter than that in ＜ 3 scores patients[(20.5 ± 8.2) d vs.(23.9 ± 11.9) d,P＜ 0.05].Multiple Logistic regression analysis showed that gender,age,tumor location,histological differentiation,Dukes stages,surgical and colorectal cancer complications unrelated (P ＞ 0.05),NRS2002 score associated with colorectal cancer complications (P ＜ 0.05).Pearson correlation analysis showed that hospital stay correlated with NRS2002 score (P ＜ 0.01).Conclusions NRS2002 score is applicable in Chinese colorectal cancer patients.The youth and the elderly,the proximal part of colon,and Dukes D stage patients are more liable to develop preoperative nutritional risk than those of middle age,the distal part of colon,or other Dukes stages.≥ 3 scores predicts higher postoperative complications and longer hospital stay.Preoperative nutritional support is necessary in patients with ≥ 3 scores.
