894例食管癌术前营养风险危险因素分析与预后  

Risk factors and prognosis for 894 cases of esophageal neoplasm patients with preoperative nutritional risk

作　　者：汤敏[1] 潘琪[1] 吴俊伟[1] 田希贵 刘德森[1] 

机构地区：[1]广西医科大学附属肿瘤医院胸外科,南宁530021

出　　处：《中华胸心血管外科杂志》2015年第7期385-387,共3页Chinese Journal of Thoracic and Cardiovascular Surgery

摘　　要：目的探讨食管癌患者术前营养风险状况与预后的关系，分析营养风险的危险因素。方法回顾性分析894例食管癌切除患者的临床资料。根据营养风险评分进行分组，总评分〈3分为无营养风险组，总评分≥3分为营养风险组。采用单因素分析术前营养风险状况对术后并发症、住院时间的影响，多因素logistic回归分析术前营养风险的独立危险因素。结果营养风险组491例，无营养风险组403例。营养风险组术后并发症发生比例明显高于无营养风险组（33．60％对19．60％），差异有统计学意义（P=0．001）；营养风险组与无营养风险组术后严重并发症比较（23．01％对8．68％）、平均住院日比较[（37．20±13．89）天对（31．69±13．49）天]，差异均有统计学意义（P〈0．05）。Logistic回归分析结果显示，患者年龄（OR=1．58，95％CI：1．101～2．268）、入院症状条目数（OR=7．97，95％CI：6．071—10．463）、入院症状严重程度（OR=0．26，95％CI：0．186—0．385）、入院饮食状况（OR=0．62，95％CI：0．482～0．813）是发生术前营养风险的独立危险因素（P〈0．05）。结论年龄≥60岁、入院症状多、入院症状严重、入院饮食情况差的食管癌患者容易发生营养风险。存在营养风险的患者住院时间延长，易发生术后并发症。Objective To provide the reference basis for reducing the occurrence of nutritional risk by analyzing possible risk factors for nutritional risk status and investigating the relationship between preoperative nutritional risk status and prognosis. Methods We retrospectively analyzed the clinical data of 894 patients（ nutritional risk group of 491 cases, non-nutritional risk group of 403 cases） with esophageal cancer resection. The univariate analysis was used to analyze the relationships between nutritional risk status with postoperative complications and length of hospitalization. And the multiple Logistic regression model analysis was applied to analyze the risk factors of nutritional risk status. Results The nutritional risk group had a higher rate of postoperative complications （33.60 % vs. 19.60 %, U = - 3. 429,P = 0. 001 ）, higher incidence of serious complications （23.01% vs. 8.68%, U = - 3.611, P = 0. 000） and longer hospital stays [ （37. 20 ±13.89 ） days vs. （31.69 ±13.49 ） days, t =4. 124, P = 0. 000] than that of non-nutritional risk group. The results of the multiple logistic regression analysis showed that the preoperative nutritional risk factors were associated with the patients age （ OR = 1.58, 95% CI： 1. 101 - 2. 268 ） , number of symptoms entries （ OR = 7.97, 95% CI：6.071 - 10. 463 ）, symptom severity（ OR = 0.26, 95% C1：0. 186 -0. 385 ） , and dietary intake（ OR =0. 62, 95% CI：0. 482 -0. 813 ） , P 〈0. 05 for all. Conclusion Theolderpatientswith more severe symptoms and poor diet are more likely to suffer from nutritional risk. Prolonged hospital stay and postoperative complications easily happen in patients with nutritional risk. So patients with preoperative nutritional risk should be given timely and effective nutrition intervention measures, in order to reduce postoperative complications and length of hospitalization.

关 键 词：食管肿瘤 食管切除术 营养风险 危险因素 预后 

分 类 号：R541.4[医药卫生—心血管疾病]