中华临床营养杂志
中華臨床營養雜誌
중화림상영양잡지
CHINESE JOURNAL OF CLINICAL NUTRITION
2014年
2期
82-86
,共5页
肝癌%营养评价%患者主观整体评估%肌酐-身高指数%Child-Pugh分级%临床结局
肝癌%營養評價%患者主觀整體評估%肌酐-身高指數%Child-Pugh分級%臨床結跼
간암%영양평개%환자주관정체평고%기항-신고지수%Child-Pugh분급%림상결국
Liver cancer%Nutritional assessment%Patient-Generated Subjective Global Assessment%Creatinine-height index%Child-Pugh classification%Clinical outcomes
目的 评估外科肝癌患者营养状况及其与肝功能分级和临床结局的相关性.方法 2011年10月至2013年10月新入院接受手术治疗的肝硬化肝癌患者112例,采用肌酐-身高指数(CHI)、上臂围、握力和蛋白代谢指标等方法,以及患者主观整体评估(PG-SGA)分别进行营养状况评估;采用Child-Pugh分级评价肝脏功能,统计术后感染并发症和术后住院日作为临床结局指标.分析营养状况与肝脏功能、临床结局的相关性.结果 根据PG-SGA分级,112例患者中70例(62.5％)营养正常,34例(30.4％)有中度营养不良,8例(7.1％)重度营养不良.以PG-SGA结果为标准,CHI法(κ=0.760,P=0.000)、上臂围法(κ=0.564,P=0.000)及握力(κ=0.523,P=0.000)均与PG-SGA一致,其中CHI法与PD-SGA法吻合程度最强.肝功能Child-Pugh分级与PG-SGA分级之间呈显著正相关(rs =0.829,P=0.000),PG-SGA分级与感染并发症及术后住院日均呈显著正相关(r =0.349,P=0.000;r =0.624,P=0.000).结论 PD-SGA结合CHI可较为准确地评估外科肝癌患者营养状况.患者的营养状况与肝脏功能分级、感染并发症发生率和术后住院日呈正相关.
目的 評估外科肝癌患者營養狀況及其與肝功能分級和臨床結跼的相關性.方法 2011年10月至2013年10月新入院接受手術治療的肝硬化肝癌患者112例,採用肌酐-身高指數(CHI)、上臂圍、握力和蛋白代謝指標等方法,以及患者主觀整體評估(PG-SGA)分彆進行營養狀況評估;採用Child-Pugh分級評價肝髒功能,統計術後感染併髮癥和術後住院日作為臨床結跼指標.分析營養狀況與肝髒功能、臨床結跼的相關性.結果 根據PG-SGA分級,112例患者中70例(62.5％)營養正常,34例(30.4％)有中度營養不良,8例(7.1％)重度營養不良.以PG-SGA結果為標準,CHI法(κ=0.760,P=0.000)、上臂圍法(κ=0.564,P=0.000)及握力(κ=0.523,P=0.000)均與PG-SGA一緻,其中CHI法與PD-SGA法吻閤程度最彊.肝功能Child-Pugh分級與PG-SGA分級之間呈顯著正相關(rs =0.829,P=0.000),PG-SGA分級與感染併髮癥及術後住院日均呈顯著正相關(r =0.349,P=0.000;r =0.624,P=0.000).結論 PD-SGA結閤CHI可較為準確地評估外科肝癌患者營養狀況.患者的營養狀況與肝髒功能分級、感染併髮癥髮生率和術後住院日呈正相關.
목적 평고외과간암환자영양상황급기여간공능분급화림상결국적상관성.방법 2011년10월지2013년10월신입원접수수술치료적간경화간암환자112례,채용기항-신고지수(CHI)、상비위、악력화단백대사지표등방법,이급환자주관정체평고(PG-SGA)분별진행영양상황평고;채용Child-Pugh분급평개간장공능,통계술후감염병발증화술후주원일작위림상결국지표.분석영양상황여간장공능、림상결국적상관성.결과 근거PG-SGA분급,112례환자중70례(62.5％)영양정상,34례(30.4％)유중도영양불량,8례(7.1％)중도영양불량.이PG-SGA결과위표준,CHI법(κ=0.760,P=0.000)、상비위법(κ=0.564,P=0.000)급악력(κ=0.523,P=0.000)균여PG-SGA일치,기중CHI법여PD-SGA법문합정도최강.간공능Child-Pugh분급여PG-SGA분급지간정현저정상관(rs =0.829,P=0.000),PG-SGA분급여감염병발증급술후주원일균정현저정상관(r =0.349,P=0.000;r =0.624,P=0.000).결론 PD-SGA결합CHI가교위준학지평고외과간암환자영양상황.환자적영양상황여간장공능분급、감염병발증발생솔화술후주원일정정상관.
Objective To investigate the relationship of the nutritional status with liver function and clinical outcomes of liver cancer patients treated with surgery.Methods Altogether 112 hospitalized patients undergoing surgical treatments for liver cancer were enrolled from October 2011 to October 2013.Their general clinical data were collected,including creatinine-height index (CHI),arm circumference,grip strenghth,albumin,prealbumin,and transferrin.The nutritional status was assessed using Patient-Generated Subjective Global Assessment (PG-SGA).The liver function was assessed with Child-Pugh classification.Postoperative infectious complications and the hospital stays were recorded to assess the clinical outcomes.The correlation between nutritional status and liver function,and that between nutritional status and clinical outcomes were analyzed.Results Among the 112 patients,70 (62.5％) were in normal nutritional status,34 (30.4％) were with moderate malnutrition,and 8 (7.1％) were with severe malnutrition according to PG-SGA scores.PG-SGA assessment showed strong consistence with CHI nutritional assessment (κ =0.760,P =0.000),and moderate consistence with arm circumference assessment (κ =0.564,P =0.000),and grip strength assessment (κ =0.523,P =0.000).The live function classified by Child-Pugh was found highly correlated with PG-SGA assessment (rs =0.829,P =0.000).Postoperative infectious complications and hospital stays were both positively correlated with PG-SGA assessment (r =0.349,P =0.000 ; r =0.624,P =0.000).Conclusions PD-SGA combining with CHI can be used for the nutritional status assessment of liver cancer patients undergoing surgical treatments.The nutritional status of the patients has positive correlation with live function,infectious complications,and postoperative hospital stays.
