胃癌根治术患者术前营养情况与术后早期并发症发生的关系  

Relationship Between Preoperative Nutritional Status and Early Postoperative Complications in Patients with Radical Gastrectomy

作　　者：门中俊 侯潇峰 孙万日[1] MEN Zhongjun;HOU Xiaofeng;SUN Wanri(Nanyang Central Hospital,Nanyang,473000)

机构地区：[1]河南省南阳市中心医院,473000

出　　处：《实用癌症杂志》2024年第6期988-991,1003,共5页The Practical Journal of Cancer

摘　　要：目的分析胃癌根治术患者术前营养情况与术后早期并发症发生的关系。方法选取240例行胃癌根治术患者,统计术后30 d内并发症发生情况,根据Clavien-Dindo分级系统进行分组,分为无早期并发症组(171例)、一般早期并发症组(48例)、严重早期并发症组(21例)。统计患者一般资料及术前营养指标[血清白蛋白(ALB)、血红蛋白(Hb)、整体营养状况主观评定法(PG-SGA)评分],采用多项Logistic回归分析胃癌根治术患者术后早期并发症发生的影响因素。采用ROC曲线分析术前营养指标预测胃癌根治术患者术后早期并发症发生的价值。结果严重早期并发症组、一般早期并发症组血清ALB、Hb水平低于无早期并发症组,PG-SGA评分高于无早期并发症组(P<0.05);严重早期并发症组血清ALB、Hb水平低于一般早期并发症组,PG-SGA评分高于一般早期并发症组(P<0.05)。logistic回归分析显示,与无早期并发症组相比,ALB、Hb、PG-SGA评分均是胃癌根治术患者术后一般早期并发症、严重早期并发症发生的影响因素(P<0.05)。ROC曲线显示,血清ALB(AUC=0.702,95%CI=0.636~0.761)、Hb(AUC=0.740,95%CI=0.676~0.796)、PG-SGA评分(AUC=0.772,95%CI=0.711~0.826)及联合评估(AUC=0.859,95%CI=0.805~0.902)一定程度上可预测胃癌根治术患者术后早期并发症的发生风险。结论术前营养情况可影响胃癌根治术患者术后早期并发症的发生,ALB、Hb、PG-SGA评分在预测术后早期并发症方面具有一定价值,且联合预测价值更高。Objective To analyze the relationship between preoperative nutrition and early postoperative complications in patients with radical gastrectomy.Methods A total of 240 patients underwent radical gastrectomy were selected and the incidence of complications within 30 days after surgery was analyzed.According to the Clavien-Dindo grading system,the patients were divided into a group with no early complications(171 cases),a group with general early complications(48 cases)and a group with severe early complications(21 cases).General data of patients and preoperative nutritional index evaluation(serum albumin(ALB),hemoglobin(Hb),patient-generated subjective global assessment(PG-SGA)score)were collected.Multiple Logistic regression was used to analyze the influencing factors of early postoperative complications in patients with radical gastrectomy.ROC curve was used to analyze the value of preoperative nutritional indexes in predicting the occurrence of early postoperative complications in patients with radical gastrectomy.Results Serum ALB and Hb levels in severe early complications group and general early complications group were lower than those in no early complications group,and PG-SGA scores were higher than those in no early complications group(P<0.05).Serum ALB and Hb levels in severe early complications group were lower than those in general early complications group,and PG-SGA scores were higher than those in general early complications group(P<0.05).logistic regression analysis showed that,compared with the group without early complications,ALB,Hb and PG-SGA scores were all influencing factors for the occurrence of common early complications and serious early complications after radical gastrectomy(P<0.05).ROC curve showed that serum ALB(AUC=0.702,95%CI=0.636~0.761),Hb(AUC=0.740,95%CI=0.676~0.796),PG-SGA score(AUC=0.772,95%CI=0.711~0.826)and combined assessment(AUC=0.859,95%CI=0.805~0.902)can predict the risk of early postoperative complications in patients with radical gastrectomy to a certain extent.Conclusi

关 键 词：胃癌根治术 营养状况 早期并发症 影响因素 预测价值 

分 类 号：R735.2[医药卫生—肿瘤]