BMI可影响结直肠癌患者术前内外科合并症状态:基于DACCA的真实世界数据研究  

BMI of colorectal cancer patients will affect preoperative medical and surgical complications: A real world study based on DACCA

作　　者：刘勇[1] 杨猎龙 汪晓东[1] 李立[1] 周总光[1] LIU Yong;YANG Lielong;WANG Xiaodong;LI Li;ZHOU Zongguang(Department of Gastrointestinal Surgery,West China Hospital,Sichuan University,Chengdu 610041,P.R.China;West China School of Clinical Medicine,Sichuan University,Chengdu 610041,P.R.China)

机构地区：[1]四川大学华西医院胃肠外科,成都610041 [2]四川大学华西临床医学院,成都610041

出　　处：《中国普外基础与临床杂志》2021年第12期1637-1644,共8页Chinese Journal of Bases and Clinics In General Surgery

基　　金：四川省科技计划项目(项目编号:2021KJTS0055);四川大学大学生创新创业项目(项目编号:C2022119081)。

摘　　要：目的分析目前版本的四川大学华西肠癌数据库(Database from Colorectal Cancer,DACCA)中,四川大学华西医院诊治的结直肠癌患者的体质量指数(BMI)对内外科合并症的影响。方法本次数据分析选取的DACCA版本为2021年9月27日更新版,其中分析的数据项目包括BMI、外科合并症、肝脏结节、肝功能、肾脏结节、肾功能、手术史、内科合并症、糖尿病、高血压、肺炎、肺部结节、肺功能、心脏病变、血栓和心功能。结果按照条件筛选DACCA数据库获得5 305条可分析数据行。以中国四分类方法划分BMI,分析结果表明:就外科合并症而言,肥胖患者更容易合并消化系统的外科合并症(χ^(2)=43.883,P<0.001)以及生殖系统的外科合并症(χ^(2)=13.139,P=0.004),偏瘦患者更容易出现泌尿系统的外科并发症(χ^(2)=223.415,P<0.001),肥胖者肝功能(H=61.521,P<0.001)、肾功能(H=9.994,P=0.019)可能更差;就手术史而言,结直肠癌患者的BMI与其曾接受的手术次数(H=6.262,P=0.100)、各系统或科室的手术史情况均无关(P>0.05);就内科合并症而言,随着BMI的增加,结直肠癌患者合并糖尿病(χ^(2)=118.597,P<0.001)或高血压(χ^(2)=163.334,P<0.001)的风险增加;BMI低的患者则更可能合并肺炎(H=7.899,P=0.048)以及更差的肺功能(H=40.673,P<0.001)。结论 DACCA数据库分析结果提示:BMI与各系统或科室的手术史无相关性。由于患者的内外科合并症与治疗方案和患者预后紧密相关,因此在临床治疗过程中要更注意肥胖患者群体,他们出现多系统、多指标异常的可能性较其他患者更高;而对于偏瘦患者,要更关注他们肺功能状态及肺部的炎性病变,以此提高临床上的治疗效果。objective To analyze the impact of body mass index(BMI) on medical and surgical complications of colorectal cancer patients served by West China Hospital, based on the current version of Database from Colorectal Cancer(DACCA). Methods The data of DACCA was updated on September 27, 2021. The data included BMI, surgical complications, liver nodules, liver function, renal nodules, renal function, operation history, medical complications,diabetes, hypertension, pneumonia, pulmonary nodules, pulmonary function, heart disease, thrombosis, and cardiac function. Results After scanning, 5 305 data rows were included. BMI was divided by Chinese four classification methods. The analysis results showed that in terms of surgical complications, obese patients were more likely to be complicated with surgical complications of digestive system(χ^(2)= 43.883, P<0.001) and reproductive system(χ^(2)=13.139,P=0.004). Lean patients were more likely to have surgical complications of urinary system(χ^(2)=223.415, P<0.001), and obese patients had liver function(H=61.521, P<0.001) and renal function(H=9.994, P=0.019) might be even worse. In terms of operation history, BMI in colorectal cancer patients had nothing to do with the number of times of operation(H=6.262, P=0.100), and operation history of each system or department(P>0.05). Regarding to medical complications,with the increase of BMI, the risk of colorectal cancer patients with diabetes mellitus(χ^(2)=118.597, P<0.001), or hypertension(χ^(2)= 163.334, P< 0.001) increased. Patients with low BMI were more likely to have pneumonia(H=7.899, P=0.048) and worse pulmonary function(H=40.673, P<0.001). Conclusions The analysis results of DACCA database show that BMI is not related to the occurrence of any special surgical history included in the research. Because the internal and external complications of patients are closely related to the treatment plan and prognosis, we should pay more attention to the obese patients in the process of clinical treatment, and they are more likely t

关 键 词：结直肠癌 体质量指数 数据库 外科合并症 手术史 内科合并症 

分 类 号：R735.34[医药卫生—肿瘤]