控制营养状态评分在预测机器人辅助食管癌根治术后并发症中的应用  

Prognostic value of CONUT score in predicting postoperative complications following robot-assisted McKeown esophagectomy

作　　者：姬雨行 曹雄 苏嘉诚 韩彪[1,2] JI Yuxing;CAO Xiong;SU Jiacheng;HAN Biao(The First Clinical Medical College of Lanzhou University,Lanzhou 730030,China;Department of Thoracic Surgery,the First Hospital of Lanzhou University/The International Science and Technology Cooperation Base for Development and Application of Key Technologies in Thoracic Surgery,Lanzhou 730030,China)

机构地区：[1]兰州大学第一临床学院,甘肃兰州730030 [2]兰州大学第一医院胸外科·胸外科关键技术研发与应用专业甘肃省国际科研合作基地,甘肃兰州730030

出　　处：《机器人外科学杂志(中英文)》2025年第4期660-666,共7页Chinese Journal of Robotic Surgery

基　　金：甘肃省科技创新人才计划(24YFWA011)。

摘　　要：目的:讨论术前控制营养状态(CONUT)评分对行达芬奇机器人辅助食管癌Mckeown术(RAME)后患者并发症的预测价值。方法:回顾性分析2019年3月—2024年3月于兰州大学第一医院行RAME的203例患者,依据COUNT评分将患者分为高CONUT组(≥3分,n=34)与低CONUT组(<3分,n=169),对比两组患者的临床特征与术后并发症差异,采用Logistic回归分析探讨影响患者术后并发症的因素。结果:高CONUT组患者术后总体并发症的发生率、吻合口狭窄、吻合口瘘、胸腔积液、切口感染的发生率显著高于低CONUT组(P<0.05)。术前胆固醇计数、COUNT评分为影响术后并发症的可能危险因素,COUNT评分≥3分为预测RAME术后患者并发症的独立危险因素(P<0.05)。结论:COUNT评分可作为RAME术后患者并发症发生的一个强有力的独立预测指标,有助于为患者提供精确且及时的个体化治疗和干预以改善预后。Objective:To investigate the predictive value of the preoperative Controlling Nutritional Status(CONUT)score for postoperative complications in patients undergoing robot-assisted McKeown esophagectomy(RAME).Methods:A retrospective analysis was performed on 203 patients who underwent RAME at the First Hospital of Lanzhou University from March 2019 to March 2024.Patients were divided into the high-CONUT group(≥3 points,n=34)and the low-CONUT group(<3 points,n=169)based on preoperative CONUT scores.Clinical characteristics and postoperative complications were compared between the groups of patients.Logistic regression analysis was used to identify risk factors for complications.Results:The high-CONUT group showed significantly higher incidence of overall postoperative complications,anastomotic stricture,anastomotic leakage,pleural effusion,and surgical site infection compared to the low-CONUT group(P<0.05).Preoperative cholesterol levels and CONUT score were identified as potential risk factors for complications,with a CONUT score≥3 points serving as an independent predictor of postoperative complications for RAME(P<0.05).Conclusion:The CONUT score is a robust independent predictor of complications following RAME,enabling precise and timely individualized interventions to improve patient prognosis.

关 键 词：机器人辅助手术 控制营养状态评分 食管癌 并发症 预测价值 

分 类 号：R571[医药卫生—消化系统]