喉癌术后患者营养风险与并发症的关系及营养支持情况分析  

Relationship between nutritional risk of postoperative patients with laryngeal carcinoma and their complications and analysis of nutritional support

作　　者：孙彩霞[1] 杨徐静[2] 张长怡[2] 

机构地区：[1]浙江省温州医科大学附属第一医院护理部,325000 [2]浙江省温州医科大学附属第一医院耳鼻咽喉科,325000

出　　处：《中华全科医学》2015年第2期304-305,308,共3页Chinese Journal of General Practice

摘　　要：目的应用营养风险筛查表NRS 2002(Nutritional Risk Screening)评估喉癌术后患者的营养状况,分析其与患者术后并发症的关系,并且探讨其临床意义和对策。方法采用NRS 2002评定标准,对2009年1月—2013年10月温州医科大学附属第一医院181例喉癌术后患者进行营养风险筛查(NRS 2002),应用χ2检验分析营养风险评分与喉癌术后并发症的关系,同时比较不同肠外营养支持患者预后情况的差别。结果在181例喉癌术后患者中,存在营养风险(NRS≥3)78例(43.09%,78/181)。181例患者中出现术后并发症的有43例(23.75%,43/181),其中有营养风险的33例,无营养风险的(NRS<3)10例。有营养风险的喉癌术后患者并发症的发生率42.31%(33/78),显著高于无营养风险患者的9.71%(10/103),差异有统计学意义(χ2=26.04,P<0.01);随着肠内营养(PN,parenteral nutrition)+肠外营养(EN,enteral nutrition)支持时间的延长,患者术后并发症发生率逐渐下降;肠内营养+氨基酸+脂肪乳组患者较肠内营养+氨基酸组患者伤口甲级愈合率明显增高,拆线时间和平均住院日明显缩短。结论喉癌术后患者中相当一部分患者存在营养风险,有营养风险的喉癌术后患者并发症发生率高,适当延长营养支持时间有利于降低术后并发症的发生,全方位营养支持有利于患者的预后。Objective To evaluate the nutritional status of postoperative patient with laryngeal carcinoma by using Nutritional Risk Screening（ NRS） 2002,analyze the relationship between their nutritional status and complications as well as explore its clinical significance and strategy. Methods NRS 2002 was used to screen nutritional risk of 181 cases of postoperative patients with laryngeal carcinoma from January 2009 to October 2013. The relationship between nutritional risk score and complications was analyzed. The difference in prognosis was compared in postoperative patients of laryngeal carcinoma with different PN（ parenteral nutrition） support. Results Based on NRS≥3,78 in 181 cases of postoperative patients of laryngeal carcinoma（ 43. 09%） were in nutritional risk. In all postoperative patients,43 cases（ 23. 75%） suffered from postoperative complications,of which 33 cases were in nutritional risk. Only 10 cases were not in nutritional risk,based on NRS≤3. The incidence of complications in postoperative patients of laryngeal carcinoma in nutritional risk was significantly higher than that of postoperative patients of laryngeal carcinoma out of nutritional risk（ 42. 31%,33 /78 vs. 9. 71%,10 /103; χ^2= 26. 04,P〈0. 01）. With extended support time of PN（ parenteral nutrition） and EN（ enteral nutrition）,the incidence of complications decreased in postoperative patients of laryngeal carcinoma. The patients with EN,amino acid as well as intralipid support had higher A-level wound healing rate,shorter suture-removing time and inpatient time compared to those with other nutrition support. Conclusion A considerable percentage of postoperative patients with laryngeal carcinoma were in nutritional risk. The postoperative patients with laryngeal carcinoma in nutritional risk are more inclined to suffer from postoperative complications. To extend nutrition support properly is good for the decrease of incidence of postoperative complications. Meanwhile,the comprehensive nutrition support will cont

关 键 词：喉癌 术后 营养风险筛查 并发症 预后 

分 类 号：R739.65[医药卫生—肿瘤] R459.3[医药卫生—临床医学]