预后营养指数对老年病人肝癌切除术后腹腔感染预测价值研究  

The predictive value of PNI for post-operative intra-abdominal infections in gerontal liver cancer patients

作　　者：李超[1] 苗润晨 张靖垚[2,3] 刘昌 LI Chao;MIAO Run-chen;ZHANG Jing-yao(Department of General Surgery, the First Affiliated Hospital of Xi'an Jiaotong University, Xi' an 710061, China)

机构地区：[1]西安交通大学第一附属医院普通外科,陕西西安710061 [2]西安交通大学第一附属医院肝胆外科,陕西西安710061 [3]西安交通大学第一附属医院SICU,陕西西安710061

出　　处：《中国实用外科杂志》2019年第6期590-593,共4页Chinese Journal of Practical Surgery

基　　金：国家自然科学基金资助项目(No.81601672,No.81773128,No.81871998)

摘　　要：目的探讨预后营养指数(PNI)对老年肝癌切除术后病人发生腹腔感染的预测价值。方法回顾性分析西安交通大学第一附属医院收治的270例行手术切除治疗老年原发性肝癌病例资料。采用受试者工作曲线(ROC)、多因素分析及生存曲线确定术前PNI对术后腹腔感染的预测价值。结果共筛选出34例腹腔感染病人,累积发生率为12.59%(34/270)。术前PNI预测术后并发腹腔感染的最佳截断值为47.58(P<0.05)。合并糖尿病、贫血及PNI<47.58是肝癌切除术后并发腹腔感染的独立危险因素(P<0.05)。PNI<47.58的腹腔感染病人术后近期总体存活率和无复发存活率均较低,但差异无统计学意义(P>0.05)。结论术前PNI对老年肝癌切除术后病人并发腹腔感染具有一定的预测价值。Objective To investigate the predictive significance of prognostic nutritional index(PNI)for intraabdominal infections(IAIs)in gerontal liver cancer patients who received hepatectomy.Methods The clinical data of270 gerontal(age≥60 y)patients with primary liver cancer(PLC)who received hepatectomy in the First Affiliated Hospital of Xi’ an Jiaotong University were retrospectively analyzed.Receiver operating characteristic curve(ROC),multivariate analysis and survival curve were used to conduct the predictive significance of preoperative PNI for IAIs.Results The incidence of IAIs was 12.59%(34/270)in this cohort.The cut-off value of preoperative PNI for the prediction of postoperative IAIs was 47.58(P<0.05).Patients with diabetes mellitus,anemia and PNI<47.58 were demonstrated as the independent risk factors for postoperative IAIs(P<0.05,respectively).Patients with PNI<47.58 suffered lower but not significantly short-term over-all and disease-free survival rate(P>0.05).Conclusion Preoperative PNI determination has predictive value for postoperative IAIs in gerontal liver cancer patients who received hepatectomy.

关 键 词：预后营养指数 老年病人 原发性肝癌 腹腔感染 

分 类 号：R6[医药卫生—外科学]