术前控制营养状态评分在老年胃癌患者术后短期并发症中的应用价值

Application value of controlling nutritional status score in short-term postoperative complications of elderly patients with gastric cancer

目的探讨术前控制营养状态评分在老年胃癌患者术后短期并发症中的应用价值。方法回顾分析统计2015年1月—2020年12月在江苏大学附属医院接受治疗的确诊胃癌患者,根据纳入标准和排除标准,选择入组患者,收集纳入研究患者一般资料、术前实验室检测数据和术后并发症情况,计算控制营养状况(CONUT)评分,统计分析CONUT营养评分在老年胃癌患者接受胃癌D2根治术术后短期并发症的价值。结果共223例患者纳入研究,CONUT评分的截断值为2.5,肿瘤直径的截断值为2.75 cm。CONUT评分>2.5组的平均年龄高于CONUT评分<2.5组(P=0.0053),且2组性别构成存在差异,男性患者多于女性(P=0.0370)。CONUT评分>2.5组患者的肿瘤直径较大(P=0.0394)。在术后并发症方面,CONUT评分>2.5组的术后并发症多于CONUT评分<2.5组(P=0.0083)。单因素Logistic回归分析,年龄(OR=1.127;95%CI:1.028~1.236;P=0.011)、CONUT评分(OR=0.339;95%CI:0.151~0.764;P=0.009)是患者发生短期并发症的危险因素。多因素Logistic回归分析显示年龄(OR=1.115;95%CI:1.008~1.233;P=0.035)、CONUT评分(OR=0.414;95%CI:0.175~0.982;P=0.045)是患者发生短期并发症的危险因素。结论CONUT评分作为老年胃癌患者术前营养评估项目可以有效预测患者术后短期并发症,进而提前进行营养干预,降低术后并发症发生率。

Objective To explore the value of controlling nutritional status score in short-term postoperative complications of elderly patients with gastric cancer.Methods The data of patients who confirmed gastric cancer and treated in the Affiliated Hospital of Jiangsu University from January 2015 to December 2020 were reviewed and analyzed.Patients were selected according to the inclusion criteria and exclusion criteria,the general data,preoperative laboratory test data and postoperative complications of the included patients were collected,and the controlling nutritional status(CONUT)score was calculated.The value of CONUT score in the short-term complications of elderly gastric cancer patients undergoing D2 radical gastrectomy for gastric cancer was evaluated.Results A total of 223 patients were included in this study.The cut-off value of CONUT score was 2.5 and the cut-off value of tumor diameter was 2.75 centimeter.The average age of the group with CONUT score>2.5 was significantly higher than that of the group with CONUT score<2.5(P=0.0053).Moreover,there was significant difference between the sex ratio of the two groups,with male more than female(P=0.0370).The tumor diameter was significantly larger in the group with CONUT score>2.5(P=0.0394).In terms of postoperative complications,there was significantly more postoperative complications in the group with CONUT score>2.5 than in the group with CONUT score<2.5(P=0.0083).Univariate logistic regression analysis showed that age(OR=1.127;95%CI:1.028-1.236;P=0.011)and CONUT score(OR=0.339;95%CI:0.151-0.764;P=0.009)were the risk factors for shortterm complications.Multivariate logistic regression analysis showed that age(OR=1.115;95%CI:1.008-1.233;P=0.035)and CONUT score(OR=0.414;95%CI:0.175-0.982;P=0.045)were the risk factors for short-term complications.Conclusions As a preoperative nutritional evaluation item for elderly patients with gastric cancer,CONUT score can effectively predict the short-term postoperative complications of patients,and then carry out nutritional intervention in advance to reduce the incidence of postoperative complications.