营养风险筛查表2002对胰腺癌患者术前营养的评估  

Nutritional Risk Screening 2002 used for preoperative nutritional assessment of patients with pancreatic cancer

作　　者：韩冰[1] 徐庆祥[1] 丁义涛[1] 卞晓洁[2] 仇毓东[1] 周铁[1] 毛谅[1] 谢敏[1] 包善华[1] 

机构地区：[1]南京大学医学院附属鼓楼医院普通外科,210008 [2]南京大学医学院附属鼓楼医院普通外科药剂科

出　　处：《中华肝胆外科杂志》2016年第3期150-154,共5页Chinese Journal of Hepatobiliary Surgery

基　　金：国家自然科学基金青年基金（81300338）;江苏省消化疾病临床医学中心项目（BL2012001）

摘　　要：目的探讨营养风险筛查表（NRS2002）用于胰腺癌患者术前营养评估的价值。方法搜集2012年3月至2014年12月在南京大学医学院附属鼓楼医院普通外科接受术前NRS2002营养风险评估的胰腺癌手术患者91例，NRS2002I〉3认为有营养风险。依据评估结果将患者分为有营养风险组（51例）和无营养风险组（40例），比较两组患者术前术后多项营养学指标、术后并发症发生率、体力状态、生活质量、住院时间、医疗费用及格拉斯哥预后评分。结果营养风险组患者术前体质量指数为22．4±1．8、肱三头肌皮褶厚度为（14．6±3．7）mm、上臂围为（26．1±3．7）cm、上臂肌肉周径为（21．5±2．5）cm，均明显低于无营养风险组的24．5±1．6、（16．5±4．0）mm、（28．2±4．1）cm和（23．0±2．9）cm（P〈0．05）。营养风险组患者术前术后各时间点血清前白蛋白、术后1天血清白蛋白，术后4和7天转铁蛋白水平显著低于无营养风险组（P〈0．05）。营养风险组与无营养风险组术后总并发症（25／51比8／40）、手术部位并发症（22／51比7／40）、非手术部位并发症（11／51比2／40）、术后7天Karnofsky功能状态评分、术后7天体力状态评分、生活质量评分、外源性人血白蛋白使用量、术后住院时间、住院费用及格拉斯哥预后评分的差异均具有统计学意义（均P〈0．05）。结论胰腺癌手术患者术前营养状况影响术后康复；NRS2002能有效评估胰腺癌患者术前营养状态，预判术后营养风险，推荐作为胰腺癌患者术前评估的方法。Objective To investigate the value of the Nutritional Risk Screening 2002 （NRS2002） for preoperative nutritional assessment of patients with pancreatic cancer. Methods Ninety-one patients who had undergone surgery in the Department of General Surgery, the Affiliated Drum Tower Hospital of Nanjing University Medical School from March 2012 to December 2014 were included into this study. These patients had all underwent preoperative nutritional assessment using NRS2002. According to the results of the NRS2002 evaluation, all these patients were divided into two groups, the nutritional risk group （51 pa- tients） with a score of NRS2002 1〉 3 and the non-nutritional risk group （ 40 patients ） with a score of NRS2002 〈 3. The preoperative and postoperative nutritional indicators, postoperative complications, physi- cal state and quality of life, length of postoperative hospital stay, and medical costs were compared between the two groups. Results The anthropometric measurements in the risk group were significantly lower than that of the no risk group. These included the body mass index （ 22.4 ± 1.8 vs 24. 5± 1.6 ） , triceps skinfold thickness （ 14. 6±3.7 vs 16. 5± 4. 0） mm, mid-arm circumference （26. 1 ± 3.7 vs 28.2 ± 4. 1 ） cm, and midarm muscle circumference （21.5 ±2. 5 vs 23.0 ± 2. 9 ） （ P 〈 0. 05 ）. Similarly, in the risk group, the preoperative and postoperative prealbumin, albumin on postoperative day 1, and transferrin on postoperative day 4 and day 7 were significantly lower than that of the no risk group. In addition, there were significant differences between the two groups in postoperative complication rates （25/51 vs 8/40） , surgical site com plications （22/51 vs 7/40）, non-surgical site complications （11/51 vs 2/40）, Karnofsky Performance Sta- tus, Zubrod-ECOG-WHO, Quality of Life, dosage of albumin, length of postoperative hospital stay, medical cost and Glasgow prognostic score. Conelttsions The nutritional status of patients with pancreatic cancer

关 键 词：营养风险筛查表2002 胰腺癌 营养风险 术前评估 

分 类 号：R473.73[医药卫生—护理学]