直肠癌患者根治术后并发症影响因素分析及PG-SGA评分的预测价值  

Predictive effect of PG-SGA score on the incidence of complications after surgical treatment of colon cancer patients

作　　者：张宜南[1] 许畅[1] 朱珠 王梅香[1] Zhang Yinan;Xu Chang;Zhu Zhu;Wang Meixiang(Jiangsu Cancer Hospital,Jiangsu Institute of Cancer Prevention and Treatment,Tumor Hospital Affiliated to Nanjing Medical University,Jiangsu Nanjing 210009,China.)

机构地区：[1]江苏省肿瘤医院&江苏省肿瘤防治研究所&南京医科大学附属肿瘤医院

出　　处：《现代肿瘤医学》2019年第21期3831-3834,共4页Journal of Modern Oncology

基　　金：江苏省卫生计生委课题(编号:S2017007);常州市卫生计生委科技项目(编号:WZ201703)

摘　　要：目的:研究直肠癌患者根治术后并发症的影响因素,分析主观全面评定法(PG-SGA)评分对其预测价值。方法:选取2017年1月至2018年10月在我院接受手术治疗的198例直肠癌患者,根据PG-SGA评分表对所有患者进行营养筛查,观察所有患者并发症发生情况;采用Logistics回归性分析分析直肠癌患者术后发生并发症的危险因素。结果:198例患者发生切口并发症17例(8.59%)、吻合口并发症14例(7.07%)、造口并发症6例(3.03%)、肺部感染8例(4.04%)、泌尿系统感染7例(3.54%),总并发率为52例(26.26%);将52例出现并发症的患者按照临床指征进行分类观察,结果发现年龄≥65岁、有合并症、美国麻醉师协会(ASA)分级为3-4级、低分化、PG-SGA评分≥4分的患者术后并发症发生率较高,差异具有统计学意义(P<0.05);将年龄≥65岁、有合并症、ASA分级为3-4级、低分化、PG-SGA评分≥4分等因素纳入Logistics回归分析,结果显示ASA评级(3-4级)、PG-SGA(≥4分)是术后发生并发症的独立危险因素(P<0.05),术前PG-SGA≥4分患者术后发生并发症的几率是正常患者的1.638倍。结论:术前PG-SGA评分≥4分的直肠癌患者术后发生并发症的概率较高,临床应根据患者自身情况给予营养支持及加强并发症的防范。Objective:To study the predictive value of PG-SGA score in postoperative complications of colon cancer patients.Methods:198 cases of rectal cancer patients who received surgical treatment in our hospital from January 2017 to October 2018 were selected.According to the PG-SGA rating scale,nutritional screening was conducted for all patients,and complications were observed in all patients.Risk factors for postoperative complications in patients with rectal cancer were analyzed by Logistics regression analysis.Results:There were 17 cases(8.59%)of incision complications,14 cases(7.07%)of anastomotic complications,6 cases(3.03%)of ostomy complications,8 cases(4.04%)of pulmonary infection,and 7 cases(3.54%)of urinary system infection in 198 cases of rectal cancer,with a total complication rate of 52 cases(26.26%).The 52 patients with complications were classified and observed according to clinical indications.The results showed that the incidence of postoperative complications was higher in patients aged 65 years or older,with comorbidity,grade 3 to 4 ASA,low differentiation,and PG-SGA score greater than 4,and the difference was statistically significant(P<0.05).Logistics regression analysis showed that ASA rating(3-4),PG-SGA(4 or higher)were independent risk factors of postoperative complications(P<0.05).For patients with preoperative PG-SGA≥4 scores,postoperative complications probability was 1.638 times of normal patients.Conclusion:The incidence of postoperative complications in rectal cancer patients with PG-SGA score≥4 before operation was higher.Nutritional support and prevention of complications should be given according to the patient's own condition.

关 键 词：PG-SGA评分 危险因素 术后并发症 直肠癌 

分 类 号：R735.37[医药卫生—肿瘤]