术前低蛋白血症与直肠癌患者术后并发症的关系:基于DACCA的真实世界数据研究  

Relation between preoperative hypoproteinemia and postoperative complications in patients with rectal cancer:A real-world data study based on DACCA database

作　　者：林雨昕 王涵硕 贾林·呼安尼西 张乐萱 王利亚 汪晓东[1] 李立[3] LIN Yuxin;WANG Hanshuo;Jialin·Huannixi;ZHANG Lexuan;WANG Liya;WANG Xiaodong;LI Li(Division of Gastrointestinal Surgery,Department of General Surgery,West China Hospital,Sichuan University,Chengdu 610041,P.R.China;West China School of Medicine,Sichuan University,Chengdu 610041,P.R.China;Department of General Surgery Ⅱ,West China Hospital of Shangjin,Sichuan University,Chengdu 611731,P.R.China)

机构地区：[1]四川大学华西医院普通外科,胃肠外科病房,成都610041 [2]四川大学华西临床医学院,成都610041 [3]四川大学华西上锦医院普外二科,成都611731

出　　处：《中国普外基础与临床杂志》2025年第3期305-312,共8页Chinese Journal of Bases and Clinics In General Surgery

基　　金：四川大学华西医院“1·3·5工程”人工智能项目(项目编号:ZYAI24067)。

摘　　要：目的分析当前版本华西肠癌数据库(Database from Colorectal Cancer,DACCA)中术前低蛋白血症对直肠癌患者术后并发症发生的影响。方法根据制定的筛选条件,从2024年4月更新版DACCA中提取直肠癌患者资料,统计术前低蛋白血症及并发症发生情况;同时,采用单因素和多因素logistic回归分析,探究直肠癌患者术后3个阶段(术后在院、近期及远期)并发症发生的风险因素。检验水准α=0.05。结果共纳入1440例直肠癌患者,术前有和无低蛋白血症直肠癌患者分别为322例(22.4%)和1118例(77.6%)。与术前无低蛋白血症直肠癌患者相比,术前有低蛋白血症直肠癌患者的年龄更大(P<0.001)、身体质量指数更小(P<0.001)、肿瘤缘距更小(P=0.032)及pTNM分期Ⅳ期患者占比更高(P<0.001)。术前有和无低蛋白血症者在术后3个阶段(术后在院、近期及远期)的总体并发症发生率比较差异均无统计学意义(χ^(2)=0.399,P=0.280;χ^(2)=0.298,P=0.585;χ^(2)=1.416,P=0.234),具体并发症除了尿潴留之外,其他并发症发生率在二者间比较差异均无统计学意义(P>0.05)。单因素和多因素logistic回归分析并未发现术前低蛋白血症是术后并发症发生的风险因素(P>0.05)。结论本研究结果提示,直肠癌患者术前低蛋白血症发生率较高;术前有低蛋白血症患者较术前无低蛋白血症患者年龄偏大、身体质量指数偏小、pTNM分期Ⅳ期者占比较高,但本研究并未发现术前低蛋白血症是直肠癌患者术后并发症发生的风险因素。Objective To analyze the impact of preoperative hypoproteinemia on postoperative complications in patients with rectal cancer based on the current version of the Database from Colorectal Cancer(DACCA).Methods The patient information was extracted from the updated version of DACCA in April 2024 according to predefined inclusion criteria.The preoperative hypoproteinemia and incidence of complications were analyzed.The univariate and multivariate logistic regression analyses were performed to identify risk factors for complications in three postoperative periods(in-hospital,short-term,and long-term).The test level was α=0.05.Results A total of 1440 patients with rectal cancer were included,322(22.4%)with preoperative hypoproteinemia and 1118(77.6%)without.Compared to the patients without preoperative hypoproteinemia,those with preoperative hypoproteinemia were older(P<0.001),had a lower body mass index(P<0.001),smaller tumor margins(P=0.032),and a higher proportion of patients with pTNM stage Ⅳ(P<0.001).There were no statistically significant differences in the overall incidence of complications during the three postoperative periods(in-hospital,short-term,and long-term)between the patients with and without preoperative hypoproteinemia(χ^(2)=0.399,P=0.280;χ^(2)=0.298,P=0.585;χ^(2)=1.416,P=0.234).Except for urinary retention,there were no significant differences in the incidence of specific complications between the two groups(P>0.05).The univariate and multivariate logistic regression analyses did not identify preoperative hypoproteinemia as a risk factor for postoperative complications(P>0.05).Conclusions The results of this study suggest that the incidence of preoperative hypoproteinemia is higher in patients with rectal cancer.Patients with preoperative hypoproteinemia tend to be older,have a lower body mass index,and a higher proportion of pTNM stage Ⅳ.However,it was not found that preoperative hypoproteinemia is a risk factor for postoperative complications.

关 键 词：直肠癌 低蛋白血症 术后并发症 术前体质状态 

分 类 号：R73[医药卫生—肿瘤]