术前预后营养指数、炎症标志物与结直肠癌患者预后及术后并发症的关系研究  

Study on the Correlation Preoperative Prognostic Nutrition Index,Inflammatory Markers, Prognosis and Postoperative Complications in Patients with Colorectal Cancer

作　　者：韦斌[1] 钟晓刚[1] 麦威[1] 黄顺荣[1] 牙韩清[1] 王晓通[1] WEI Bin;ZHONG Xiao-gang;MAI Wei;HUANG Shun-rong;YA Han-qing;WANG Xiao-tong(Surgical Treatment of Gastrointestinal Hernia and Fistula,People's Hospital of Guangxi Zhuang Autonomous Region,Nanning,Guangxi,530021,China)

机构地区：[1]广西壮族自治区人民医院胃肠疝肠瘘外科,广西南宁530021

出　　处：《现代生物医学进展》2022年第4期746-751,共6页Progress in Modern Biomedicine

基　　金：广西壮族自治区卫生和计划生育委员会自筹经费科研项目(Z2015363,Z2016580)。

摘　　要：目的:探讨术前预后营养指数(PNI)、炎症标志物与结直肠癌患者预后、术后并发症的关系。方法:纳入我院2017年12月~2019年12月收治的结直肠癌患者150例行回顾性分析。在手术前,评估患者的PNI,并采血检测血小板计数(PLT)、中性粒细胞数(NE),计算PLT与淋巴细胞比值(PLR)、NE与淋巴细胞比值(NLR)。分析患者术后并发症情况,并分成并发症组、无并发症组,根据术后12个月的预后情况,分成生存组、死亡组。比较术后有无并发症及不同预后患者的PNI、PLR、NLR,分析影响结直肠癌患者术后并发症及预后的影响因素。结果:在150例患者中,术后有26例(17.33%)发生并发症,124例(82.67%)无并发症;术后12个月内死亡19例(12.67%),生存131例(87.33%)。并发症组术前PNI低于无并发症组,PLR、NLR高于无并发症组(P<0.05),死亡组术前PNI低于生存组,PLR、NLR高于生存组(P<0.05)。Logistic多元回归模型分析显示:开腹手术、术前营养风险、术中出血量≥200 m L、PLR≥147.98、NLR≥2.86是患者术后并发症发生的危险因素,PNI≥51.94是预防术后并发症的保护性因素(P<0.05)。COX多因素模型分析显示:临床分期为Ⅲ期、肿瘤直径>4 cm、脉管癌栓、浸润深度为T3+T4、PLR≥147.98、NLR≥2.86是患者死亡的危险因素,PNI≥51.94是预防死亡的保护性因素(P<0.05)。结论:术前PNI下降以及PLR、NLR升高会增加结直肠癌患者术后并发症以及死亡风险,三者是患者术后并发症与预后不良的影响因素。Objective: To explore the relationship between preoperative nutritional index, inflammatory markers and the prognosis and postoperative complications of patients with colorectal cancer. Methods: A retrospective analysis of 150 patients with colorectal cancer who were admitted to our hospital from December 2017 to December 2019 was included. Before surgery, the patient’s prognostic nutritional index(PNI) was assessed, and collect blood to detect platelet count(PLT) and neutrophil count(NE), and the ratio of platelet-lymphocyte ratio(PLR) and neutrophil-lymphocyte ratio(NLR) were calculated. The postoperative complications of the patients were analyzed, and they were divided into complication group and non-complication group. According to the prognosis of 12 months after operation, they were divided into survival group and death group. The PNI, PLR, and NLR of patients with or without postoperative complications and different prognosis were compared, and influence factor affecting postoperative complications and prognosis of patients with colorectal cancer were analyzed. Results: Among 150 patients, postoperative 26 cases(17.33%) had complications, 124cases(82.67%) had no complications, 19 cases(12.67%) died within 12 months after operation, and 131 cases(87.33%) survived. The preoperative PNI of the complication group was lower than that of the non-complication group, the PLR and NLR were higher than those of the non-complication group(P<0.05), the preoperative PNI of the death group was lower than that of the survival group, and the PLR and NLR were higher than that of the survival group(P<0.05). Logistic multiple regression model analysis shows that: open surgery,preoperative nutritional risk, intraoperative blood loss ≥200 m L, PLR ≥147.98, NLR ≥2.86 were risk factors for postoperative complications in patients, and PNI≥51.94 was protective factor to prevent postoperative complications(P<0.05). Cox multivariate model analysis showed that: clinical stage Ⅲ, tumor diameter>4 cm, vascular tumor thrombu

关 键 词：结直肠癌 预后营养指数 炎症标志物 预后 并发症 

分 类 号：R735.3[医药卫生—肿瘤]