胰腺癌患者围手术期体重丢失的现状调查及影响因素分析  

Investigation of current status and analysis of influencing factors of perioperative weight loss in patients with pancreatic cancer

作　　者：陈乐英[1] 查庆华 田秋菊 张世瑜[3] 黄仲妍 张敏[1] 陈喆[1] 董紫芸 韦筱燕 CHEN Leying;ZHA Qinghua;TIAN Qiuju;ZHANG Shiyu;HUANG Zhongyan;ZHANG Min;CHEN Zhe;DONG Ziyun;WEI Xiaoyan(Department of Pancreatic Surgery,Ruijin Hospital,Shanghai JiaoTong University School of Medicine,Shanghai 200025,China;Department of Nursing,Ruijin Hospital,Shanghai JiaoTong University School of Medicine,Shanghai 200025,China;Department of General Surgery,Ruijin Hospital,Shanghai JiaoTong University School of Medicine,Shanghai 200025,China)

机构地区：[1]上海交通大学医学院附属瑞金医院胰腺外科,上海200025 [2]上海交通大学医学院附属瑞金医院护理部,上海200025 [3]上海交通大学医学院附属瑞金医院普外科,上海200025

出　　处：《重庆医学》2023年第S01期48-53,共6页Chongqing medicine

基　　金：上海交通大学医学院附属瑞金医院护理科研基金项目(RJHK-2022-4)。

摘　　要：目的描述胰腺癌患者围手术期体重丢失的现状,并分析其影响因素。方法选取2021年9月至2022年2月本院收治的180例胰腺恶性肿瘤患者作为研究对象,收集患者入院时(T0)、术前1 d(T1)、术后7 d(T2)、出院准备阶段(T3)的体重,以及人口学资料、疾病、治疗、营养状况相关资料,采用广义估算方程分析胰腺癌患者围手术期体重丢失的影响因素。结果与TO比较,T1体重丢失了0.81%(0,1.55%),T2体重累积丢失了4.13%(2.99%,5.79%),T3体重累积丢失了7.44%(5.44%,11.11%)。BMI、血清清蛋白、血红蛋白水平呈下降趋势。T1、T3的NRS2002分别为(1.96±1.05)、(5.37±1.37)分,T1、T3的PG-SGA分别为(3.35±1.56)、(9.13±3.72)分。多因素分析结果显示:CCI6分、新辅助化疗、手术方式为PD、TP、TP、PG-SGA、摄入能量、摄入蛋白质、C级胰瘘、肠瘘是胰腺癌围手术期体重丢失率的影响因素(P<0.05)。结论临床医护人员应关注胰腺癌患者全病程的体重丢失及营养状况。Objective To investigate and describe the current status of perioperative weight loss in patients with pancreatic cancer and analyze its influencing factors.Methods A total of 180 patients with pancreatic malignant tumor admitted to our hospital from September 2021 to February 2022 were selected as research objects.The body weight of patients at admission(T0),1 d before surgery(T1),7 d after surgery(T2),and at the stage of preparation for discharge(T3)were collected,as well as the relevant data of demographic data,disease,treatment,and nutritional status.The influence factors of perioperative weight loss in pancreatic cancer patients were analyzed by generalized estimation equation.Results Compared with TO,T1 lost 0.81%(0,1.55%),T2 lost 4.13%(2.99%,5.79%)and T3 lost 7.44%(5.44%,11.11%).The levels of BMI,serum albumin and hemoglobin showed a downward trend.The NRS2002 scores of T1 and T3 were(1.96±1.05)and(5.37±1.37),respectively.The PG-SGA scores of T1 and T3 were(3.35±1.56)and(9.13±3.72),respectively.The results of multivariate analysis showed that CCI6 score,neoadjuvant chemotherapy,surgical methods PD,TP,TP,PG-SGA,energy intake,protein intake,grade C pancreatic fistula and intestinal fistula were influencing factors of perioperative weight loss rate of pancreatic cancer(P<0.05).Conclusion Clinical staff should pay attention to weight loss and nutritional status of pancreatic cancer patients throughout the course of the disease.

关 键 词：胰腺癌 围手术期 体重丢失 营养 

分 类 号：R735.9[医药卫生—肿瘤]