术前营养风险评估对老年直肠癌患者围手术期营养状况的影响

Effect of preoperative nutritional risk to postoperative nutritional status of elderly rectal cancer patients

目的分析营养风险评估对老年直肠癌患者围手术期营养状况的影响。方法应用营养风险筛查2002（NRS-2002）对85例老年直肠癌患者进行术前营养风险筛查，根据筛查结果将患者分为有营养风险组25例和无营养风险组60例，分别于术前1d、术后1d、术后7d检测两组患者的白蛋白（ALB）、前白蛋白（PALB）、血总淋巴细胞计数（TLC）和转铁蛋白（TFN），比较其差异。结果术前85例患者中25例NRS-2002≥3分，存在营养风险，营养风险发生率为29．4％。术前1d两组患者各血清指标比较差异均无统计学意义（P〉0．05）；术后1d，营养风险组PALB为（12．4±3．7）mg／L低于无营养风险组（14．3±3．9）mg／L，两组比较，差异有统计学意义（1=2．026，P〈0．05）；术后7d营养风险组ALB、TFN值低于无营养风险组，两组比较，差异有统计学意义（t分别为2．412，2．153；P〈O．05）。结论存在营养风险的老年直肠癌患者围手术期营养状况变化明显，临床护理人员应对该类患者进行相应的营养指导。

Objective To investigate the effect of nutritional risk to nutritional status of peroperative elderly rectal cancer patients. Methods 85 elderly patients with rectal cancer were screened for preoperative nutritional status by NRS-2002 and divided into nutritional risk group and non-nutritional risk group. ALB, PALB, TLC and TFN of two groups were measured 1 day before operation, 1 day and 7 days after operation. The values were compared between two groups. Results Before operation, 25 patients out of 85 were at nutritional risk with NRS-2002≥3 and incidence of nutritional risk of 29.4%. The PALB value of the nutritional risk group was significantly lower than that of the non-nutritional risk group 1 day after operation [ （ 12.4±37 ） mg/L vs （ 14.3±3.9） mg/L; t = 2. 026, P 〈 O. 05 ~. After 7 days, the average levels of all indexes of the nutritional risk group were lower than those of the non-nutritional risk group. Among those, differences of ALB and TFN values between two groups were significant （ t = 2. 412, 2. 153, respectively ; P 〈 0.05 ）. Conclusions Perioperative nutritional status of elderly rectal cancer patients at nutritional risk changes conspicuously and should be given relevant nutritional auidance bv nurses.