结直肠癌患者营养风险筛查及对术后感染风险的影响  

Nutritional risk screening of patients with colorectal cancer and its impact on postoperative infection

作　　者：郎华风[1] 赵芳[1] 胡金灵[1] 张彬[2] 陈培[1] LANG Hua-feng ZHAO Fang HU Jin-ling ZHANG Bin CHEN Pei(People＇s Hospital of Anji, Huzhou, Zhejiang 313300, China)

机构地区：[1]安吉县人民医院外二科,浙江湖州313300 [2]安吉县人民医院外一科,浙江湖州313300

出　　处：《中华医院感染学杂志》2017年第4期839-841,845,共4页Chinese Journal of Nosocomiology

基　　金：2014年浙江省医药卫生一般研究计划(2014KYB305)

摘　　要：目的筛查结直肠癌患者营养风险并分析其对患者术后感染风险的影响,为降低术后感染提供依据。方法收集2008年1月-2016年6月医院收治的结直肠癌患者206例,使用营养风险筛查量表(NRS 2002)对结直肠癌患者营养风险进行筛查,并根据NRS 2002将患者分为研究组(≥3分)和对照组(<3分),其中研究组82例,对照组124例;主要观察指标为两组患者术后总感染率和切口感染率。结果与对照组比较,研究组患者总感染率显著增高(15.85%vs.3.23%,P=0.003);切口感染率显著增高(8.54%vs.0.81%,P=0.015);另外研究组患者红细胞(t=3.395)、白蛋白(t=3.352)、前白蛋白(t=5.834)、血红蛋白(t=2.853)和BMI(t=4.124)水平显著低于对照组(P<0.05);单因素和多因素logistic回归分析显示术前NRS评分增加、BMI降低和白蛋白减少是结直肠癌患者术后感染的危险因素(P<0.05)。结论 NRS≥3分的结直肠癌患者术后感染率显著增高,应加强NRS≥3分的结直肠癌患者的肠内营养支持。OBJECTIVE To screen the nutritional risk of patients with colorectal cancer and observe its impact on postoperative infection so as to provide guidance for prevention of the postoperative infection.METHODS A total of206 patients with colorectal cancer who were treated in the hospital from Jan 2008 to Jun 2016 were enrolled in the study,then the nutritional risk of the participants was screened by using nutritional risk scale（NRS 2002）,the enrolled patients were divided into the study group with 82cases（no less than 3points）and the control group with 124cases（less than 3points）according to the NRS 2002,and the total incidence rate of postoperative infection and incidence rate of incision infection were observed and compared between the two groups of patients.RESULTS The total incidence rate of postoperative infection of the study group was 15.85%,significantly higher than 3.23% of the control group（P=0.003）;the incidence rate of incision infection of the study group was8.54%,significantly higher than 0.81% of the control group（P=0.015）.The levels of red blood cells（t=3.395）,albumin（t=3.352）,prealbumin（t=5.834）,hemoglobin（t=2.853）,and BMI（t=4.124）were significantly lower in the study group than in the control group（P〈0.05）.Univariate and multivariate logistic regression analysis showed that increase of preoperative NRS score,decrease of BMI,and reduction of albumin level were the risk factors for the postoperative infection in the patients with colorectal cancer（P〈0.05）.CONCLUSIONThe incidence rate of postoperative infection is remarkably high in the colorectal cancer patients with the NRS score no less than 3points.It is necessary to strengthen the enteral nutrition support of the colorectal cancer patients with the NRS score no less than 3points.

关 键 词：结直肠癌 营养风险筛查量表 感染 

分 类 号：R619.3[医药卫生—外科学]