胃肠道肿瘤患者术后营养状况及其影响因素研究

Nutritional status and its influencing factors in postoperative patients with gastrointestinal cancer

目的调查胃肠道肿瘤患者术后的营养状况并分析其影响因素,为改善患者恢复期营养状况提供科学依据。方法通过病历复习的方式,寻找符合纳入标准的研究对象,邀约病人返院进行回访,对患者目前的营养状况进行评价,并根据营养评价得分将病人分为营养良好组和营养不良组。对患者年龄、性别、受教育程度、肿瘤部位、肿瘤分期、手术前BMI、手术期间体重下降程度、是否化疗、术后时间等相关指标进行分析。结果共调查142例,其中营养状况良好者89人占62.7%,营养状况不良者53人占37.3%。营养良好组患者年龄、受教育程度、手术期间体重下降程度以及术后时间与营养不良组比较,差异均具有统计学意义(P<0.05);进一步多因素Logistic回归分析显示,年龄、手术期间体重下降程度、术后时间是胃肠道肿瘤患者术后恢复期营养状况的影响因素。结论高龄、手术期间体重下降≥5%是胃肠道肿瘤患者术后恢复期营养不良的独立危险因素,同时,随着手术后时间的延长,患者的营养状况得到了相应的改善,但营养不良问题仍然突出。

Objective To study the nutritional status and its influencing factors in postoperative patients withgastrointestinal（GI） cancer.Methods The data of GI cancer patients meeting the inclusion criteria were collected by reviewingmedical records and inviting the patients back to the hospital to evaluate their nutritional status. The patiens were divided intonormal nutrition group and malnutrition group based on the scores of nutritional assessment. The indicators of age,gender,education,results of diagnosis,BMI before the operation,weight loss during the operation,chemotherapy and the time after theoperation were analyzed.Results A total of 142 GI cancer patients were investigated and the nutritional status of 89 caseswas normal accounted for 62.7%, and 53 cases was with malnutrition status accounted for 37.3%. Significant differences werenoticed in age, weight loss during the preoperative period,the level of education and the length of time after the operationbetween the two groups （P〈0.05）.Muhivariate unconditional logistic regression analysis revealed that the age,weight loss ≥5%during the preoperative period and the length of time after the operation were the factors influencing postoperative nutritionalstatus of the cases Conclusions Age and the high percentage of weight loss during the preoperative period were theindependent risk factors of malnutrition in patients after the operation.In addition,as the extension of the operation duration ,thenutritional status of cases was improved but malnutrition obviously exist in the patients.