不同评分系统对胃癌伴幽门梗阻患者术前营养状态评估的比较  

Comparison with different scoring system for preoperative nutritional status of gastric cancer patients with pyloric obstruction

作　　者：杨东 郑志超 赵岩 张涛 刘勇 YANG Dong;ZHENG Zhi-chao;ZHAO Yan;ZHANG Tao;LIU Yong(Department of Gastric Surgery,Cancer Hospital of China Medical University/Liaoning Cancer Hospital&Institute,Shenyang 110042,China)

机构地区：[1]中国医科大学肿瘤医院/辽宁省肿瘤医院胃外科,110042

出　　处：《天津医药》2018年第8期865-868,共4页Tianjin Medical Journal

基　　金：辽宁省自然科学基金资助项目(20170540567)

摘　　要：目的比较患者主观整体评估法(PG-SGA)及营养风险筛查表(NRS2002)评分系统用于进展期胃癌伴幽门梗阻患者术前营养状态评估的优劣。方法选取2016年7月—2017年7月在辽宁省肿瘤医院经病理学及影像学检查确诊为胃癌伴幽门梗阻患者114例,对入组患者分别采用PG-SGA及NRS2002评分系统评估术前营养状态,以血清白蛋白<30 g/L为诊断营养不良的金标准,通过应用受试者工作特征(ROC)曲线分析2种评分系统对进展期胃癌伴幽门梗阻患者术前营养状态评估的敏感度及特异度。结果 114例患者根据血清白蛋白诊断营养不良为80例(70.1%),PG-SGA的ROC曲线下面积(AUC)为0.858,NRS2002为0.706。对患者术前诊断营养不良的敏感度PG-SGA为88.75%,NRS2002为77.50%,特异度PG-SGA为85.29%,NRS2002为76.47%。结论 PG-SGA评分系统更适合于进展期胃癌伴幽门梗阻患者术前营养状态的评估,有较高的敏感度和特异度。Objective To compare patient generated subjective global assessment(PG-SGA)and nutritional risk screening table(NRS2002)scoring systems in preoperative nutritional status assessment of patients with advanced gastric cancer and pyloric obstruction.Methods A total of 114 patients from the Department of Gastric Surgery of the Liaoning Cancer Hospital were selected between July 2016 and July 2017.All patients were confirmed gastric cancer with outlet obstruction by gastroscopy and histopathology.All patients were treated with PG-SGA,NRS2002 scoring systems were used to assess the preoperative nutritional status.The serum albumin<30 g/L was used as the gold standard for the diagnosis of malnutrition.The receiver operating characteristic(ROC)curve was used to analyze the sensitivity and specificity of PGSGA and NRS2002 scoring systems in patients with preoperative evaluation of nutritional status of gastric cancer with pyloric obstruction.Results Eighty cases(70.1%)were diagnosed as malnutrition by serum albumin in 114 patients.The area under the PG-SGA curve(AUC)was 0.858 and NRS2002 was 0.706.The sensitivity of PG-SGA to preoperative diagnosis of malnutrition in patients with advanced gastric cancer and pyloric obstruction was 88.75%,NRS2002 was 77.50%,the specificity of PG-SGA was 85.29%,and NRS2002 was 76.47%.Conclusion The PG-SGA scoring system is more suitable for the assessment of preoperative nutritional status in patients with advanced gastric cancer and pyloric obstruction,and has a high diagnostic efficiency.

关 键 词：胃肿瘤 幽门 胃出口梗阻 营养不良 敏感度与特异度 营养评估 

分 类 号：R735.2[医药卫生—肿瘤] R573.6[医药卫生—临床医学]