| 高从荣,范 军,裴韶华,岳 晖,陈李李.食管癌患者术前营养风险评估及与术后吻合口瘘和住院时间的关系研究[J].,2022,(16):3132-3136 |
| 食管癌患者术前营养风险评估及与术后吻合口瘘和住院时间的关系研究 |
| Preoperative Nutritional Risk Assessment of Patients with Esophageal Cancer and its Relationship Study with Postoperative Anastomotic Fistula and Length of Hospital Stay |
| 投稿时间：2022-02-06 修订日期：2022-02-28 |
| DOI：10.13241/j.cnki.pmb.2022.16.027 |
| 中文关键词: 食管癌 营养风险 吻合口瘘 住院时间 |
| 英文关键词: Esophageal cancer Nutritional risk Anastomotic fistula Length of hospital stay |
| 基金项目:安徽省卫生厅医学科研基金项目（13zc021） |
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| 中文摘要: |
| 摘要 目的：评估食管癌患者术前营养风险及其影响因素，并分析其与术后吻合口瘘和住院时间的关系。方法：回顾性分析2017年1月至2020年12月在合肥市第二人民医院胸外科行手术治疗的105例食管癌患者的临床资料，患者术前均完善营养风险筛查表-2002（NRS-2002）对其营养风险的评估，根据评估结果分为营养风险组（≥3分，43例）和无营养风险组（＜3分，62例），采用单因素及多因素Logistic回归分析食管癌患者术前营养风险的影响因素，比较不同术前营养风险状态患者术后吻合口瘘发生率以及住院时间的差异。结果：食管癌患者的术前营养风险较高，营养风险发生率为40.95%（43/105）。单因素分析结果显示，营养风险组年龄≥65岁、入院体质量指数＜18.5 kg/m2、术前接受过新辅助放化疗、过去1周膳食摄入不足、术前白蛋白＜35 g/L的患者比例高于无营养风险组（P＜0.05）。多因素Logistic回归分析结果显示，术前接受过新辅助放化疗、过去1周膳食摄入不足、术前白蛋白＜35 g/L是食管癌患者术前存在营养风险的危险因素（P＜0.05）。营养风险组术后胸腔吻合口瘘、颈部吻合口瘘发生率高于无营养风险组（P＜0.05），住院时间长于无营养风险组（P＜0.05）。结论：术前新辅助放化疗、过去1周膳食摄入情况、术前白蛋白水平是食管癌患者术前营养风险的影响因素，术前营养风险会增加患者术后吻合口瘘发生风险，延长患者住院时间。 |
| 英文摘要: |
| ABSTRACT Objective: To evaluate the preoperative nutritional risk of patients with esophageal cancer, and to analyze its relationship with postoperative anastomotic fistula and length of hospital stay. Methods: The clinical data of 105 patients with esophageal cancer who underwent surgical treatment in the Department of Thoracic Surgery, Hefei Second People's Hospital from January 2017 to December 2020 were retrospectively analyzed. All patients completed the nutritional risk assessment of the nutritional risk screening form-2002 (NRS-2002) before surgery, and thery were divided into nutritional risk group (≥3 scores, 43 cases) and non-nutritional risk group (<3 scores, 62 cases). Multivariate Logistic regression was used to analyze the influencing factors of preoperative nutritional risk in patients with esophageal cancer, and the differences in the incidence of postoperative anastomotic fistula and length of hospital stay in patients with different preoperative nutritional risk status were compared. Results: Preoperative nutritional risk was higher in patients with esophageal cancer, and the incidence of nutritional risk was 40.95% (43/105). Univariate analysis showed that the proportion of patients in nutritional risk group with age ≥65 years, admission body mass index < 18.5 kg/m2, preoperative neoadjuvant chemoradiotherapy, inadequate dietary intake in the past 1 week, preoperative albumin < 35 g/L were higher than those in non-nutritional risk group (P＜0.05). Multivariate Logistic regression analysis showed that preoperative neoadjuvant chemoradiotherapy, inadequate dietary intake in the past 1 week, and preoperative albumin < 35 g/L were the risk factors for preoperative nutritional risk in patients with esophageal cancer(P＜0.05). The incidence of thoracic anastomotic fistula and cervical anastomotic fistula in nutritional risk group were higher than those in non-nutritional risk group (P＜0.05), and the length of hospital stay was longer than that in non-nutritional risk group (P＜0.05). Conclusion: Preoperative neoadjuvant chemoradiotherapy, dietary intake in the past 1 week, and preoperative albumin level are the influencing factors for preoperative nutritional risk of patients with esophageal cancer. Higher preoperative nutritional risk would increase the risk of postoperative anastomotic fistula and prolong the length of hospital stay of patients. |
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