小野寺预后营养指数在老年直肠癌患者中的应用  

The Clinical Application of Onodera's Prognostic Nutrition Index in Elderly Patients with Rectal Cancer

作　　者：常颖智[1] 曹杰[1] 谭卫民[1] 罗时敏[1] 

机构地区：[1]广州医学院附属广州市第一人民医院外科,广东省广州市510180

出　　处：《中华全科医学》2012年第6期841-843,共3页Chinese Journal of General Practice

摘　　要：目的探讨小野寺预后营养指数(简称小野寺指数)在老年直肠癌患者中的应用价值。方法计算52例老年直肠癌患者的小野寺指数并根据小野寺指数将全组患者分为营养良好组(小野寺指数≥45)和营养不良组(小野寺指数<45),比较两组间一般资料、手术耐受性、术后并发症及术后肠道恢复等方面的差异性,同时分析小野寺指数与直肠癌临床病理特征的相关性。结果小野寺指数与患者年龄明显相关(P=0.006),与性别则无明显相关性(P>0.05)。营养良好组患者的手术耐受性明显高于营养不良组(P<0.001),术后并发症发生率明显低于后者(P=0.025),两组的术后肛门排气、排便时间则差异无统计学意义(P>0.05)。小野寺指数与直肠癌的肿瘤大小(P=0.032)、腹膜播散(P=0.025)、远处转移(P=0.040)及TNM分期(P=0.040)密切相关。结论小野寺指数可较好地反映老年直肠癌患者的手术耐受性及风险性,并与直肠癌的恶性程度及TNM分期密切相关,是一个较有价值的直肠癌术前评估指标。Objective To study the valuation of Onodera＇s prognostic nutrition index（Onodera＇s index） in clinical application on elderly patients with rectal cancer.Methods Onodera＇s indexes of 52 elderly patients with rectal cancer were calculated and these patients were divided into well-nourished group（Onodera＇s index≥45） and malnourished group（Onodera＇s index45） and the general data,surgical tolerance,postoperative complication and the recovery of gastrointestinal function were compared between these two groups.Moreover,the correlation between Onodera＇s index and clinicopathologic features of rectal cancer was also analyzed.Results Onodera＇s index significantly correlated to age（P=0.006） but not to gender of rectal cancer（P0.05）.Patients within well-nourished group had significantly better surgical tolerance and lower postoperative complication rate than those within malnourished group（P0.001 and P=0.025,respectively）.However,there was no significant difference in postoperative recovery of gastrointestinal function between these two groups（P0.05）.Furthermore,Onodera＇s index was found to be related to tumor size（P=0.032）,peritoneal dissemination（P=0.025）,distant metastasis（P=0.040）,and TNM stage（P=0.040） of rectal cancer.Conclusion Onodera＇s index can exactly reflect the surgical tolerance and the risk of elder patients with rectal cancer and was closely related to malignancy and clinical stage of rectal caner,suggesting Onodera＇s index as a valuable preoperative predictor for rectal cancer.

关 键 词：小野寺预后营养指数 直肠癌 老年患者 手术耐受性 术后并发症 

分 类 号：R735.37[医药卫生—肿瘤]