术前衰弱联合营养状况对妇科恶性肿瘤患者延迟性术后肠麻痹的预测价值  

Predictive value of preoperative frailty combined with nutritional status for prolonged postoperative ileus in patients with gynecologic malignancies

作　　者：单蓓莹 周雨丹 吴立雪 祝文澜[1] 王继文 庄猛 孙海建 张继如[1] Shan Beiying;Zhou Yudan;Wu Lixue;Zhu Wenlan;Wang Jiwen;Zhuang Meng;Sun Haijian;Zhang Jiru(Department of Anesthesiology,Affiliated Hospital of Jiangnan University,Wuxi 214125,China;Wuxi College of Medicine,Jiangnan University,Wuxi 214125,China)

机构地区：[1]江南大学附属医院麻醉科,无锡214125 [2]江南大学无锡医学院,无锡214125

出　　处：《中华麻醉学杂志》2024年第4期406-411,共6页Chinese Journal of Anesthesiology

基　　金：无锡市中青年医疗卫生拔尖人才项目(BJ2023045);无锡市科技局医疗技术攻关项目(Y20232017);江南大学附属医院临床研究与转化医学研究项目(LCY202226)。

摘　　要：目的评价术前衰弱联合营养状况对妇科恶性肿瘤患者延迟性术后肠麻痹(PPOI)的预测价值。方法选择2022年4月至2023年2月于江南大学附属医院择期行妇科恶性肿瘤手术患者,入院24 h内采用Frail量表评估衰弱情况,采用控制营养状况评分评估营养状况。记录患者一般资料指标和PPOI发生情况,采用多因素logistic回归分析PPOI的危险因素。采用受试者工作特征曲线评价衰弱、营养状况及两者联合对PPOI的预测能力。结果最终纳入患者214例,PPOI患者52例,衰弱患者98例。术前衰弱联合中重度营养不良是妇科恶性肿瘤患者PPOI的独立危险因素(P<0.05),预测妇科恶性肿瘤患者PPOI发生的曲线下面积为0.796(95%CI 0.736~0.857)。结论术前衰弱联合中重度营养不良预测妇科恶性肿瘤患者PPOI的准确性较高。Objective To evaluate the predictive value of preoperative frailty combined with nutritional status for prolonged postoperative ileus(PPOI)in the patients with gynecological malignancies.Methods Patients undergoing elective surgery for gynecological malignancies in the Affiliated Hospital of Jiangnan University from April 2022 to February 2023 were selected.The Frail scale was used to evaluate the frailty within 24 h of admission,and the nutritional status was evaluated by the Controlling Nutritional Status score.The general characteristics of patients and occurrence of PPOI were recorded,and the risk factors for PPOI were analyzed by multivariate logistic regression.The ability of frailty,nutritional status and their combination to predict PPOI was assessed by the receiver operating characteristic curve.Results Two hundred and fourteen patients were finally included,52 cases developed of PPOI,and 98 cases were frail patients.Preoperative frailty combined with moderate to severe malnutrition was an independent risk factor for PPOI in the patients with gynecological malignancies(P<0.05),and the area under the curve in predicting the occurrence of PPOI was 0.796(95%confidence interval 0.736-0.857)in the patients with gynecological malignancies.Conclusions Preoperative frailty combined with moderate to severe malnutrition has a higher accuracy in predicting PPOI in the patients with gynecological malignancies.

关 键 词：衰弱 营养状况 手术后并发症 功能性肠阻塞 生殖器肿瘤 女(雌)性 

分 类 号：R737.3[医药卫生—肿瘤]