营养评价指标对腹腔镜全子宫切除老年患者术后并发症的预测价值  

Predictive value of nutritional evaluation indicators for complications after total laparoscopic hysterectomy in geriatric

作　　者：左东华 李凤玲 钟艳 陈维燕 李喆 李秀敏 Zuo Donghua;Li Fengling;Zhong Yan(Department of Gynecology,Linyi Tumor Hospital,Linyi 276034)

机构地区：[1]临沂市肿瘤医院妇科,临沂276034

出　　处：《现代妇产科进展》2025年第4期274-278,共5页Progress in Obstetrics and Gynecology

摘　　要：目的:探讨预后营养指数(PNI)和老年营养风险指数(GNRI)在预测腹腔镜全子宫切除(TLH)老年患者术后并发症方面的有效性。方法:回顾分析2021年6月1日至2024年7月31日于山东省临沂市肿瘤医院行TLH的120例非恶性疾病老年(60岁及以上)患者的临床资料,计算PNI和GNRI。根据术后是否出现并发症,将研究对象分为并发症组和非并发症组。比较两组患者的临床信息和术后满意度;使用受试者工作特征(ROC)曲线评估独立影响因素对老年患者发生TLH术后并发症的预测效能。根据有无营养风险,将研究对象分为营养正常组和营养异常组,比较两组患者的术后满意度。结果:单因素分析显示,血清白蛋白水平、ASA分级、PNI以及GNRI与术后并发症显著相关(均P<0.05)。多因素logistic回归分析显示,GNRI是老年TLH术后并发症的独立影响因素(P<0.05)。GNRI预测老年TLH术后并发症的ROC曲线下面积为0.826(95%CI为0.672~0.986,P<0.001)。与营养异常组患者相比,营养正常组患者的住院时长更短、术后24h舒适度及护理满意度更优(均P<0.05)。结论:GNRI可有效评估TLH老年患者的营养状态,并能有效预测其术后并发症的发生风险。Objective:To investigate the predictive value of the prognostic nutritional index(PNI)and the geriatric nutritional risk index(GNRI)for complications after total laparoscopic hysterectomy(TLH)in geriatric.Methods:We made a retrospective analysis on the baseline data of the 120 patients aged≥60 years old with non-malignant disease,who underwent TLH in Linyi Tumor Hospital from June 1,2021 to July 31,2024.PNI and GNRI were calculated.According to whether postoperative complications occurred,they were divided into complications group and non-complications group.The clinical data and postoperative satisfaction were compared between two groups,and we used the receiver operating characteristic(ROC)to discover the predictive value of the significant indicator for the complications in the elderly patients after TLH.According to the presence of nutritional abnormalities or not,they were divided into normal nutrition group and abnormal nutrition group,and postoperative satisfaction were compared between two groups.Results:There were significant difference in albumin,ASA degree,PNI and GNRI between the two groups of patients suffering complications or not(all P<0.05).Multivariate logistic analysis showed that GNRI was the independent influencing factor for complications after TLH in geriatric(P<0.05).The ROC curve showed that the AUC for GNRI in predicting complications after TLH in geriatric was 0.826(95%CI:0.672~0.986,P<0.001).There were significant difference in the length of hospital stay,the degree of comfort and satisfaction at 24 hours after surgery between the two groups of patients suffering complications or not(all P<0.05).There were also significant difference in the length of hospital stay,the degree of comfort and satisfaction at 24 hours after surgery between the two groups of patients suffering nutritional risk or not(all P<0.05).Conclusions:GNRI is more effective in assessing preoperative nutritional condition and predicting postoperative complication risk for elderly patients undergoing TLH than PNI.

关 键 词：老年营养风险指数 老年女性 腹腔镜全子宫切除术 术后并发症 

分 类 号：R737.33[医药卫生—肿瘤]