缺铁性贫血对老年胃癌术后短期预后及营养状态的影响

Impact of Iron Deficiency Anemia on Short-term Prognosis and Nutritional Status in Postoperative Gastric Cancer Patients

目的探讨缺铁性贫血对老年胃癌手术患者短期预后及营养状态的影响。方法回顾性分析中国人民解放军第101医院普外科2012~2016年因胃癌行手术治疗的老年患者104例,其中贫血组64例,对照组40例。记录患者住院天数及费用,以及术后并发症的发生率;术后随访1年,统计患者的复发/死亡率,营养状态变化,以及复查胃镜的结果。结果贫血组住院天数及费用显著高于对照组,差异有统计学意义(P<0.05);贫血组出现10例术后并发症(6例术后感染,2例吻合口瘘,2例胃排空障碍),对照组出现2例并发症(均为感染),差异无统计学意义(P>0.05)。术后随访1年,贫血组和对照组的死亡/复发率分别为18.75%和17.50%,差异无统计学意义(P>0.05);而贫血组体重及血红蛋白水平降低较对照组明显,差异有统计学意义(P<0.05);胃镜结果提示贫血组残胃炎的发生率高于对照组,差异有统计学意义(P<0.05)。结论缺铁性贫血与住院天数、费用、残胃炎的增加有关,并影响术后营养状态的恢复,术前纠正及术后预防缺铁性贫血对老年胃癌的治疗及预后有重要意义。

Objective To investigate the effect of iron deficiency anemia on short-term prognosis and nutritional status in older patients with gastric carcinoma. Methods A total of 104 older patients who underwent surgery for gastric carcinoma in 101 hos-pital of PLA from 2012 to 2016 were retrospectively analyzed. The patients were divided into anemia group (64 cases) and control group (40 cases). The postoperative complications, length of hospital stay and cost of hospitalization were recorded. After a year of follow-up. The number of patients who had relapsed or dead, nutritional status and gastroscopic appearance were reviewed. Results The number of hospitalization days and hospital costs were significantly higher in anemia group than those in the control group (P<0. 05). Postoperative complications occurred in 10 cases (6 postoperative infections, 2 anastomotic fistulas and 2 gastric emptying disorders) in anemia group, and 2 cases (postoperative infection) in the control group. After a 1 year of follow-up, mortality/re-lapse rates in two groups were 17. 50% and 17. 85% , respectively, there was no significant difference between two groups ( P >0. 05). The body weight and hemoglobin level in the anemia group were significantly lower than those in the control group (P <0. 05). Gastroscopic appearance suggested that the incidence of residual gastritis was higher in the anemia group than that in the con-trol group (P<0. 05). Conclusion Iron deficiency anemia is related to the increase of hospitalization days and costs and residual gastritis, and affects the recovery of postoperative nutritional status. Preoperative and postoperative iron deficiency anemia interven-tions will have significant effects on the treatment and prognosis of gastric carcinoma in older patients.