外科胰腺肿瘤患者营养不足和营养风险发生率的前瞻性调查研究  

A prospective observational study on nutritional status of patients with pancreatic tumor

作　　者：吕骅[1] 杨鑫[1] 丁润宇 崔红元[1] 乔江春[1] 朱明炜[1] 韦军民[1] 

机构地区：[1]北京医院普外科,100730

出　　处：《中华临床营养杂志》2017年第2期94-98,共5页Chinese Journal of Clinical Nutrition

摘　　要：目的 调查外科胰腺肿瘤患者营养不足和营养风险发生率.方法 对2014年1月至2015年12月,因各种胰腺肿瘤入住北京医院普外科,接受手术治疗的121例住院患者,根据肿瘤性质分为胰腺癌组和其他胰腺肿瘤组,主要应用营养风险筛查2002方法,前瞻性比较不同胰腺肿瘤患者的营养不足和营养风险发生率以及物理测量、 体成分和外周血蛋白质水平等,记录临床结局.结果 121例符合入选标准的胰腺肿瘤患者进入本研究,胰腺癌组90例和其他胰腺肿瘤组31例,平均年龄（61.9±13.6）岁;平均体质量指数（23.20±2.95）kg/m^2;上臂围（28.8±3.5）cm;肌肉组织量（44.6±7.4）kg;脂肪组织量（16.8±7.6）kg;两组在人体测量和体成分等方面差异无统计学意义（均P〉0.05）;胰腺癌组空腹血糖[（6.45±2.47）mmol/L]显著高于对照组[（4.95±0.79）mmol/L]（P〈0.001）,白蛋白[（39.0±4.7）g/L比（42.3±2.9）g/L,P〈0.001],总蛋白[（62.8±6.2）g/L比（66.3±2.9）g/L,P〈0.001]和前白蛋白[（136.1±85.4）mg/L比（197.8±112.6）,P=0.011]均显著低于对照组;营养不足发生率为4.1%,营养风险发生率78.5%;其中胰腺癌组营养风险发生率显著高于其他胰腺肿瘤组（91.1%比38.7%,χ^2=36.525,P〈0.001）.结论 外科胰腺癌患者营养风险发生率较高,蛋白水平低和糖代谢异常,可导致住院时间延长.Objective To investigate the rates of undernutrition and nutritional risks of surgical patients with pancreatic tumors .Methods Totally 121 surgical patients with pancreatic tumors from Department of Surgery Beijing Hospital were enrolled in a prospective study during January 2014 to December 2015 . Patients were divided into two groups：the pancreatic cancer group （ n=90 ） and other pancreatic tumor group （ n=31 ） .Nutritional Risk Screening 2002 was used to assess the nutritional status .Other data including anthropometric measure, body composition, blood biochemistry and clinical outcome were collected and analyzed.Results Among 121 patients, the mean age was （ 61.9 ±13.6 ） years, the mean body mass index was （ 23.20 ±2.95） kg/m2 , the mean mid-upper circumference was （ 28.8 ±3.5 ） cm, the mean muscle weight was （44.6 ±7.4） kg, and the mean fat mass was （16.8 ±7.6） kg .There was no significantly difference in anthropometric measurement results and body compositions between two groups （ all P〉0.05 ） .In the pancreatic cancer group, albumin [ （39.0 ±4.7） g/L vs. （42.3 ±2.9） g/L, P〈0.001], total protein [ （62.8 ±6.2） g/L vs.（66.3 ±2.9） g/L, P〈0.001], and prealbumin [ （136.1 ±85.4） mg/L vs. （197.8 ±112.6 ） mg/L, P=0.011 ] were significantly lower than those in the other pancreatic tumor group and a higher fasting blood-glucose [ （6.45 ±2.47） mmol/L vs.（4.95 ±0.79） mmol/L, P〈0.011] was found.Among all patients , the rates of undernutrition and nutritional risk were 4.1% and 78.5%, and the pancreatic cancer group had a higher rate of nutritional risk （91.1% vs.38.7%,χ^2 =36.525, P〈0.001）. Conclusion In this prospective study , surgical patients with pancreatic cancer have a high incidence of nutri -tional risk, with low protein level and abnormal glucose metabolism .

关 键 词：胰腺肿瘤 血糖 住院时间 外科患者 营养不足 营养风险筛查2002 

分 类 号：R735.9[医药卫生—肿瘤]