术前营养风险指数评估对老年髋关节置换患者预后的影响  

Influence of preoperative nutritional risk index on the prognosis of elderly patients with hip replacement

作　　者：祁富军 任鹏程 刘盼盼 闫晓东 赵建奎 QI Fujun;REN Pengcheng;LIU Panpan;YAN Xiaodong;ZHAO Jiankui(Department of Orthopaedic Anesthesia,Second Affiliated Hospital of Air Force Military Medical University,Xi'an 710038;Department of Orthopaedics,Second Affiliated Hospital of Air Force Military Medical University,Xi'an 710038,China)

机构地区：[1]空军军医大学第二附属医院骨科麻醉科,西安710038 [2]空军军医大学第二附属医院骨科,西安710038

出　　处：《中华骨与关节外科杂志》2023年第10期914-919,共6页Chinese Journal of Bone and Joint Surgery

基　　金：陕西省自然科学基础研究计划项目(2019JM-265)。

摘　　要：目的:研究老年营养风险指数(GNRI)对老年全髋关节置换术(THA)患者髋关节预后的评估价值。方法:选择2021年1月至2022年6月接受THA的老年患者87例,根据GNRI将患者分为GNRI>98分组(n=31),92分≤GNRI≤98分组(n=43)、GNRI<92分组(n=13)。根据Harris评分将患者分为预后良好组(≥80分)与预后不良组(<80分)。比较不同组别患者的一般资料,探索影响患者术后恢复不良的相关因素,并分析GNRI对于老年THA患者预后的预测价值。结果:不同GNRI分组患者的年龄、Harris评分、并发症的总发生率差异具有统计学意义(P<0.05)。GNRI<92分组患者的年龄、并发症发生率显著高于GNRI>98分组(P<0.05),GNRI<92分组患者Harris评分显著低于GNRI>98分组(P<0.05)。经单因素、多因素分析显示,年龄和GNRI是影响老年THA患者预后不良的独立危险因素(P<0.05)。绘制受试者操作特征(ROC)曲线显示,GNRI对于THA患者预后具有一定的预测价值(P<0.05),ROC曲线下面积(AUC)为0.805(95%CI:0.701~0.909)。结论:GNRI可显著影响老年THA患者术后髋关节预后情况,且术前可通过观察患者GNRI进一步预测患者术后的恢复情况,有利于临床方案的个性化调整。Objective:To investigate the value of geriatric nutrition risk index(GNRI)in evaluating the prognosis of hip joint in elderly patients after total hip arthroplasty(THA).Methods:Totally 87 elderly patients who received hip replacement in our hospital from January 2021 to June 2022 were selected and divided into group GNRI>98 scores(n=31),group 92 scores≤GNRI≤98 scores(n=43)and group GNRI<92 scores(n=13)according to GNRI score.The patients were divided into good prognosis group(Harris score≥80 points)and poor prognosis group(Harris score<80 points)according to Harris score.The general data of patients in different groups was compared,the related factors that affected the poor recovery of patients after surgery were explored,and the predictive value of GNRI for the prognosis of THA patients was analyzed.Results:There were significant differences in age,Harris score and total incidence of complications among patients with different GNRI groups(P<0.05).The age and complication rate of group GNRI<92 scores were significantly higher than that of group GNRI>98 scores(P<0.05),and the Harris score of group GNRI<92 scores was significantly lower than that of group GNRI>98 scores(P<0.05).Univariate and multivariate analysis showed that age and GNRI score were independent risk factors for poor prognosis in elderly patients with THA(P<0.05).Receiver operating characteristic curve(ROC)showed that GNRI had certain predictive value for the prognosis of THA patients(P<0.05),and its area under the curve(AUC)was 0.805(95%CI:0.701~0.909).Conclusions:GNRI score can significantly affect the prognosis of hip joint in elderly patients after THA,and preoperative observation of GNRI score can further predict the recovery of patients after surgery,which is conducive to personalized adjustment of clinical program.

关 键 词：全髋关节置换术 老年营养风险指数 髋关节功能 营养状态 预后 

分 类 号：R687[医药卫生—骨科学]