预后营养指数在腔镜辅助食管癌根治术后并发症中的预测价值  

Predictive value of prognostic nutritional index in complications after thoracoscopy-assisted esophagectomy

作　　者：迪力木拉提·买买提 居来提·艾尼瓦尔[1] 卡吾力·居买 伊力亚尔·夏合丁[1] DILIMULATI Maimaiti;JULAITI Ainiwaer;KAWULI Jumai;ILYAR Sheyhidin(Department of Thoracic Surgery,The First Affiliated Hospital of Xinjiang Medical University,Urumqi,830000,P.R.China)

机构地区：[1]新疆医科大学第一附属医院胸外科,乌鲁木齐830000

出　　处：《中国胸心血管外科临床杂志》2023年第1期89-94,共6页Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

基　　金：国家重点研发计划资助(2017YFC0909900)。

摘　　要：目的探讨预后营养指数(prognostic nutritional index,PNI)在腔镜辅助食管癌根治术后并发症中的预测价值。方法收集2015年1月—2020年6月在新疆医科大学第一附属医院行腔镜辅助食管癌根治术患者的临床资料,通过建立受试者工作特征(receiver operating characteristic,ROC)曲线评价PNI对术后总体并发症的预测价值并确定其最佳截点,根据截点进行分组,对比分析两组间一般资料及围手术期并发症相关指标的差异;用单因素和多因素分析探讨包括PNI在内的相关指标对术后并发症发生的影响。结果共纳入116例患者,其中男75例、女41例,年龄65(58~69)岁。ROC曲线下面积为0.647,其最佳截点为51.9,以该节点分组,高PNI组45例、低PNI组71例。两组患者总体并发症发生率(χ^(2)=10.437,P=0.001)、术后肺部感染发生率(χ^(2)=10.811,P=0.001)差异有统计学意义。单因素分析结果显示,呼吸机使用时间(Z=–3.136,P=0.002)、血清白蛋白值(t=2.961,P=0.004)、PNI值(χ^(2)=10.437,P=0.001)为影响腔镜辅助食管癌根治术后并发症的可能危险因素。而多因素分析结果则提示,呼吸机使用时间(OR=1.015,P=0.002)、饮酒史(OR=5.231,P=0.013)为术后并发症的独立危险因素,而高PNI为术后并发症的保护因素(OR=0.243,P=0.047)。结论PNI指数对术后并发症预测具有一定价值,可量化患者术前营养及免疫状况。饮酒史、呼吸机使用时间是腔镜辅助食管癌术后并发症的独立危险因素,高PNI为术后并发症的保护因素。Objective To investigate the predictive value of prognostic nutritional index(PNI)in complications after thoracoscopy-assisted radical resection of esophageal cancer.Methods We collected the clinical data of patients who underwent thoracoscopy-assisted esophagectomy in the First Affiliated Hospital of Xinjiang Medical University from January 2015 to June 2020.The predictive value of PNI for postoperative complications was evaluated by establishing receiver operating characteristic(ROC)curve and the optimal cut-off point was determined.The patients were divided into a high PNI group and a low PNI group according to the cut-off point.The differences of baseline data and perioperative complications-related indicators between the two groups were compared and analyzed.Univariate and multivariate analyses were used to investigate the influence of PNI and other related indexes on postoperative complications.Results A total of 116 patients were enrolled in this study,including 75 males and 41 females,aged 65(58-69)years.The area under ROC curve was 0.647,and the optimal cut-off point was 51.9.According to the cut-off point,there were 45 patients in the high PNI group and 71 patients in the low PNI group.The overall complication rate(χ^(2)=10.437,P=0.001)and the incidence of postoperative pulmonary infection(χ^(2)=10.811,P=0.001)were statistically different between the two groups.The results of univariate analysis showed that the duration of ventilator use(Z=–3.136,P=0.002),serum albumin value(t=2.961,P=0.004),and PNI value(χ^(2)=10.437,P=0.001)were the possible risk factors for postoperative complications after thoracoscopy-assisted esophagectomy.The results of multivariate analysis suggested that the duration of ventilator use(OR=1.015,P=0.002)and the history of drinking(OR=5.231,P=0.013)were independent risk factors for postoperative complications,and high PNI was the protective factor for postoperative complications(OR=0.243,P=0.047).Conclusion PNI index has a certain value in predicting postoperative complicatio

关 键 词：食管肿瘤 预后营养指数 术后并发症 

分 类 号：R735.1[医药卫生—肿瘤]