NRS2002在肝细胞癌患者术前营养评估中的应用价值  

The Clinical Value of Nutritional Risk Assessment 2002 in Preoperative Nutritional Assessment of Patients With HCC

作　　者：訾雪剑 卞晓洁[1,2] 仇毓东[1,2] 姚辉[1,2] 周铁[1,2] 毛谅[1,2] 谢敏[1,2] 

机构地区：[1]南京医科大学鼓楼临床医学院 [2]南京大学医学院附属鼓楼医院,南京210000

出　　处：《肝胆外科杂志》2014年第6期410-414,共5页Journal of Hepatobiliary Surgery

基　　金：江苏省卫生厅医学重点人才项目(RC2011003)

摘　　要：目的探讨营养风险筛查工具NRS2002在肝细胞癌(hepatocellular carcinoma,HCC)患者术前营养评估中的应用价值。方法采用回顾性研究的方法,搜集南京大学医学院附属鼓楼医院2013年3月至2014年9月术前采用NRS2002工具进行营养风险筛查的HCC手术患者70例,其中无营养风险患者36例,有营养风险患者34例,并比较两组患者术后恢复情况。结果与无风险组比较,风险组患者术后ICU入住率较高、术后第1、3天谷丙转氨酶、谷草转氨酶和术后第1天直接胆红素指标较高、术后外源性白蛋白总输注量较大、术后并发症发生率较高、术后住院时间延长以及住院费用较大,差异均有统计学意义(P<0.05);与无风险组比较,风险组患者术后血清白蛋白指标较低、肛门首次排气时间有所延长,但差异无统计学意义(P>0.05)。结论 HCC手术患者术前营养状况影响术后康复,有营养风险患者术后康复较慢、术后住院时间延长且住院费用较大;NRS2002工具用于HCC患者术前营养筛查有效可行,推荐作为HCC患者术前评估的方法。To explore the clinical value of Nutritional Risk Assessment 2002（NRS2002） in preoperative nutritional assessment of patients with HCC. Methods 70 HCC patients treated with hepatectomy at Drum Tower Hospital from March. 2013 to Sept.2014 were divided into non-risk（NR） group（n = 36） and risk（R） group（n = 34）. Patients in R group had nutritional risk assessed by NRS2002 before hepatectomy,and patients in the NR group didn＇t have nutritional risk. Data of patients of two groups were compared,which included exogenous albumin infusion,postoperative liver function,ICU admission rate,anal exhaust time,complications,length of postoperative stay,and the total hospital costs. Results The mean of data of R group was significantly higher than that of NR group in such markers as ICU admission rate,alanine aminotransferase（ALT）,aspartate transaminase（AST） on day 1,3 after hepatectomy,direct bilirubin（DB） on day 1 after hepatectomy,exogenous albumin infusion,complications,length of postoperative stay,and the total hospital costs（P〈0. 05）. There were no significant difference of albumin（ALB） and anal exhaust time between two groups（P〉0. 05）. Conclusion Patients with preoperative nutritional risk assessed by NRS2002 had worse postoperative recovery,longer postoperative stay and more hospital costs. NRS2002 for preoperative nutritional assessment in HCC patients is feasible and effective.

关 键 词：肝细胞癌 NRS2002 术前营养评估 术后恢复 

分 类 号：R735.7[医药卫生—肿瘤]