腹膜后脂肪肉瘤患者营养风险与预后的相关性研究

Nutritional risk relates to the prognosis of patients with retroperitoneal liposarcoma

目的 分析腹膜后脂肪肉瘤患者围手术期营养状况,为针对性应用营养干预提供依据.方法 收集腹膜后脂肪肉瘤患者60例,根据既往是否因腹膜后肿瘤行手术治疗将患者分为初发组（27例）和复发组（33例）,入院后24 h内完成营养风险筛查评估,并查血清白蛋白（ALB）水平.结果 术前NRS2002评分显示,复发组营养不良的发生率高于初发组.手术前后不同时间2组患者的血清白蛋白水平均下降,复发组下降趋势明显,差异有统计学意义（分别t=9.174,4.720,10.950,8.772,10.960,均P＜0.05）.复发组术后胃肠道功能恢复时间[（86±15）h]长于初发组[（61±6）h]（=7.903,P＜0.05）;复发组术后抗生素应用时间[（15.5±5.6）d]长于初发组[（7.3±0.7）d]（t=7.55,P＜0.05）;复发组术后平均住院时间[（25.5±6.0）d]长于初发组[（14.1 ±1.7）d]（=9.571,P＜0.05）;复发组住院费用[（13.2 ±5.6）万元]多于初发组[（6.8±0.9）万元]（X2=5.871,P＜0.05）.切口并发症发生率初发组1例次,复发组6例次,2组比较差异无统计学意义（x2=2.625,P＞0.05）.结论 腹膜后脂肪肉瘤患者围手术期存在营养风险,复发组患者较初发组患者的营养风险发生率高,NRS2002评分系统简单易行,可以预测营养风险.

Objective To provide evidence for the application of nutritional intervention strategy by analyzing perioperative nutritional status of retroperitoneal liposarcoma patients.Methods 60retroperitoneal liposarcoma patients were divided into primary group （27 cases） and relapse group （33cases）.These patients were put on nutritional risk evaluation using nutritional risk screening （2002）（NRS2002） within 24 hours of admission,and the serum albumin （ALB） value was recorded.Results Preoperative NRS2002 score showed that relapse group had a higher chance of cacotrophy.Serum albumin level from different time point showed that patients in relapse group were more prone to cacotrophy （respectively t =9.174,4.720,10.950,8.772,10.960,all P 〈 0.05） and subject to slower recovery of gastrointestinal function [（86 ± 15） h vs.（61 ± 6） h] （t =7.903,P 〈 0.05）,prolonged antibiotic use [（15.5 ± 5.6） d vs.（7.3 ± 0.7） d],t =7.55,P 〈 0.05）,the average length of hospital stay was longer [（25.5±6.0） d vs.（14.1 ± 1.7）d] （t =9.571,P〈0.05）,and higher inhospita cost [（13.2±5.6） ＆#215; 104 yuan vs.（6.8 ± 0.9） ＆#215; 104 yuan] （t =5.871,P 〈 0.05）.Though there was no difference between the two groups in incision complication rates （x2 =2.625,P 〉 0.05）Conclusions Retroperitoneal liposarcoma patients has perioperative nutritional risk.Compared with the primary group,patients from relapse group have higher chance to got cacotrophy.NRS2002 scoring system is simple,it could be used in predicting nutritional risk for those patients.