结直肠癌肠造口患者营养状况与生活自理能力的相关性及影响因素分析  

Correlation and influencing factors analysis of nutritional status and self nursing ability among patients underwent enterostomy due to colorectal cancer

作　　者：刘芝玉 刘茹 徐颖 张梦娟 徐姝娟[3] Liu Zhiyu;Liu Ru;Xu Ying;Zhang Mengjuan;Xu Shujuan(Graduate School of Anhui University of Traditional Chinese Medicine,Hefei Anhui,230012,China;Graduate School of Wannan Medical College,Wuhu Anhui,241002,China;Yijishan Hospital of Wannan Medical College,Wuhu Anhui,241004,China)

机构地区：[1]安徽中医药大学研究生院,安徽合肥230012 [2]皖南医学院研究生院,安徽芜湖241002 [3]皖南医学院弋矶山医院,安徽芜湖241004

出　　处：《齐齐哈尔医学院学报》2023年第18期1795-1800,F0003,共7页Journal of Qiqihar Medical University

基　　金：安徽省高等学校省级质量工程项目(2020kfkc564)。

摘　　要：目的 了解结直肠癌肠造口患者术后营养现状并分析其影响因素。方法 采用便利抽样法,对安徽省芜湖市某三级甲等医院胃肠外科2021年1月-2022年12月收治的结直肠癌拟行造口术的患者188例为研究对象,在患者入院24 h内完成营养风险筛查、血常规化验等,采用NRS 2002营养风险筛查量表评估患者的营养状况。收集患者的一般资料、营养指标检查结果。采用二分类Logistic回归分析结直肠癌肠造口患者术后营养不良的影响因素。结果 本研究共纳入符合条件的结直肠癌肠造口患者共188例,其中营养状况良好者106例(56.4%),存在营养不良者82例(43.6%)。单因素分析结果显示两组患者在年龄、BMI、有无腹部大手术史、造口持续时间、造口类型、原发疾病方面差异均有统计学意义(均P<0.05)。出院时两组患者Barthel评分差异有统计学意义(P<0.05)。Spearman相关分析显示,入院时TP、ALB、HB、RBC、LYM与日常生活自理能力具有明显相关性(P<0.05);出院时TP、HB、RBC与日常生活自理能力具有明显相关性(P<0.05)。二分类Logistic回归分析结果显示,影响结直肠癌肠造口患者术后营养状态的因素有年龄、BMI、腹部大手术史、造口类型(P<0.05)。结论 医护人员应在术前全面评估结直肠癌拟实施造口术的患者的营养状况,早期合理提供营养支持,防止术后发生重度营养不良。Objective To understand the postoperative nutrition status of patients underwent enterostomy due to colorectal cancer,and to analyze the influencing factors.Methods Convenient sampling method was employed in the study,188 cases of patients who underwent enterostomy due to colorectal cancer and were admitted to gastrointestinal surgery department of a three-level hospital in Anhui province from January 2021 to December 2022 were enrolled as study objects.Nutrition risk screening and blood routine tests were completed within 24 hours.The nutritional status of patients was assessed by using NRS 2002 nutrition risk screening scale.Patients'general data and nutritional index examination results were collected.Dichotomous Logistic regression was used to analyze the factors affecting postoperative malnutrition in colorectal cancer patients underwent enterostomy.Results A total of 188 eligible patients with colorectal cancer and underwent enterostomy were included in this study,including 106(56.4%)in good nutrition status and 82(43.6%)in malnutrition status.The results of univariate analysis showed significant differences in age,BMI,history of major abdominal surgery,duration of stoma,stoma type,and primary disease(all P<0.05).There was significant difference in Barthel scores between the two groups at discharge(P<0.05).Pearson correlation analysis showed that TP,ALB,HB,RBC,and LYM at admission were significantly associated with daily self care(P<0.05).TP,HB,and RBC were significantly associated with daily self care at discharge(P<0.05).The results of dichotomous Logistic regression analysis showed that the factors influencing postoperative nutrition status of patients underwent enterostomy due to colorectal cancer were age,BMI,history of major abdominal surgery,and type of colostomy(P<0.05).Conclusions Medical staff should comprehensively evaluate the nutritional status of patients proposed to undergo stoma before surgery,and provide reasonable nutritional support at an early stage to prevent severe postoperative malnut

关 键 词：结直肠癌 造口 营养状况 影响因素 

分 类 号：R192.6[医药卫生—卫生事业管理]