NRS 2002和PG-SGA在胃肠道恶性肿瘤患者中的应用  

Application of NRS 2002 and PG⁃SGA in Patients With Gastrointestinal Malignancies

作　　者：游利江 葛杰[2,3] 刘婷 赵庭雨 谢凯强[3,4] 刘合利 唐密密 YOU Lijiang;GE Jie;LIU Ting;ZHAO Tingyu;XIE Kaiqiang;LIU Heli;TANG Mimi(The Second Affiliated Hospital,Department of Clinical Pharmacy,Hengyang Medical School,University of South China,Hengyang,Hunan Province,421001;Department of Gastrointestinal Surgery,Xiangya Hospital,Central South University,Changsha;National Clinical Research Center for Geriatric Disorders(Xiangya Hospital),Changsha;Department of Pharmacy,Xiangya Hospital,Central South University,Changsha)

机构地区：[1]南华大学附属第二医院临床药学科,421001 [2]中南大学湘雅医院胃肠外科 [3]国家老年疾病临床医学研究中心(湘雅医院) [4]中南大学湘雅医院药学部

出　　处：《胃肠病学》2023年第7期432-436,共5页Chinese Journal of Gastroenterology

基　　金：国家自然科学基金(81803233);中国博士后科学基金第69批面上资助项目(2021M693561);湖南省卫生健康委科研课题项目(202213054567)。

摘　　要：背景:目前国内指南共识推荐对于围手术期胃肠道恶性肿瘤患者,需使用营养风险筛查2002(NRS 2002)和患者主观整体评估(PG-SGA)量表分别进行营养风险筛查和评估。但PG-SGA量表筛查专业要求更高,内容复杂,耗时长,在目前医务人员工作繁忙的情况下,仅使用NRS 2002量表进行筛查。目的:探索NRS 2002与PG-SGA对胃肠道恶性肿瘤患者营养状况和临床结局评估的相关性和一致性,探索仅使用NRS 2002进行筛查的准确性,为临床营养筛查与评估工作规范的建立提供指导。方法:回顾性分析2020年1月—2022年10月中南大学湘雅医院胃肠外科行胃肠道恶性肿瘤根治术的患者157例,采用NRS 2002和PG-SGA量表进行营养筛查与评估,收集人口学资料、营养相关实验室指标和术后短期临床结局资料。结果:存在营养风险或营养不良的患者的术前体质指数(BMI)、淋巴细胞、前白蛋白显著低于不存在营养风险或营养不良的患者(P<0.05);NRS 2002与PG-SGA的相关性(r=0.728)和一致性(κ=0.460)较好,预测术后并发症的曲线下面积(AUC)分别为0.691和0.702。此外,营养风险和营养不良患者术后并发症发生率明显增高(P<0.05)。结论:对于胃肠外科医师,在临床工作繁忙的情况下,可仅使用NRS 2002对患者进行营养筛查,并根据筛查结果进行相应的营养治疗。Background:At present,domestic guidelines and consensus recommend the use of nutritional risk screening 2002(NRS 2002)and patient⁃generated subjective global assessment(PG⁃SGA)for nutritional risk screening and assessment in patients with gastrointestinal malignancies during the perioperative period.However,PG⁃SGA has higher professional requirements,complex content and time⁃consuming.In the current busy situation of medical staff,NRS 2002 is more used for screening alone.Aims:To explore the correlation and consistency of NRS 2002 and PG⁃SGA in the assessment of nutritional status and clinical outcomes in patients with gastrointestinal malignancies,and to explore the accuracy of screening using NRS 2002 alone,so as to provide guidance for the establishment of clinical nutritional screening and assessment standards.Methods:A retrospective analysis was conducted on 157 patients with gastrointestinal malignancies who underwent radical surgery in the Department of Gastrointestinal Surgery of Xiangya Hospital,Central South University from January 2020 to October 2022.Nutritional screening and evaluation were performed by NRS 2002 and PG⁃SGA scales,and demographic data,nutrition⁃related laboratory indicators and short⁃term postoperative clinical outcomes were collected.Results:Patients with nutritional risk or malnutrition had lower body mass index(BMI),lymphocytes and prealbumin(P<0.05).The correlation and consistency of NRS 2002 and PG⁃SGA scales were good(r=0.728,κ=0.460),the areas under the curve(AUC)for predicting postoperative complications were 0.691 and 0.702,respectively.In addition,postoperative complications were significantly increased in patients with nutritional risk or malnutrition(P<0.05).Conclusions:Therefore,gastrointestinal surgeons can only use NRS 2002 to perform nutritional screening in patients and make corresponding nutritional treatment according to the screening results in the case of busy clinical work.

关 键 词：营养风险筛查2002 患者主观整体评估 胃肠肿瘤 营养评价 临床结局 

分 类 号：R735[医药卫生—肿瘤]