老年喉癌患者术后营养风险与手术并发症的相关性分析

Correlation analysis of postoperative nutritional risk and surgical complications in elderly patients with laryngeal carcinoma

目的通过应用营养风险筛查表（nutritimal risk screeing 2002,NRS 2002）评估喉癌患者术后营养风险及其与术后并发症的关系。方法采用NRS 2002量表对2010年1月-2012年12月在中南大学湘雅医院耳鼻咽喉头颈外科行喉癌手术211例患者行术后营养风险筛查,应用卡方检验分析喉癌患者的营养风险比例和喉癌患者术后并发症发生率与营养风险的关系。结果 211例喉癌患者中88例（88/211,41.7%）有营养风险;I/II期患者中4例（4/25）有营养风险,III期患者中56例（56/146）有营养风险,IV期患者中28例（28/40）有营养风险,提示临床分期较晚者营养不良风险比例明显升高（χ2=24.12,P〈0.05）;211例患者中术后出现并发症者32例,其中28例有营养风险（28/88,31.2%）,显著高于无营养风险者4例（4/123,3.3%）,差异具有统计学意义（χ2=25.07,P〈0.01）;全喉切除术后患者出现并发症者18例,其中有营养风险者出现并发症者15例（15/33,45.5%）,显著高于无营养风险出现并发症者（3例,3/10,30.0%）,差异具有统计学意义（χ2=22.03,P〈0.05）。结论喉癌术后患者中较大一部分存在营养风险且与肿瘤临床分期相关,有营养风险者术后并发症发生率高,且全喉切除术患者术后并发症发生率与营养不良风险密切相关。

Objective To evaluate the nutritional status and relationship between nutritional risk and post-operative complications through nutritional risk screening 2002（ NRS 2002） in elderly patients with laryngeal carcinoma（ LC）.Methods NRS 2002 was applied to screen nutritional risks in 211 cases suffering from LC and received surgical treatment in our department from Jan 2010 to Dec 2012. Chi-square test was adopted analyze the ratio of nutritional risk in LC patients after surgery,the relationship between incidence of postoperative complications and nutritional risk was also explored. Results Nutritional risk existed in 88 of the 211 LC patients. Nutritional risk was identified in 4 of 25 patients with clinical stage I / II,56 of 146 with stage III and 28 of 40 with stage IV,which indicated high nutritional risk was correlated with advanced clinical stage（ χ2= 24. 12,P〈 0. 05）. Complications occurred in 32 of the 211 patients. Of the32 cases,28 were accompanied with nutritional risk and 4 without nutritional risk,and the difference was statistically significant（ χ2= 25. 07,P〈 0. 01）. Complications were found in 18 of 43 patients received total laryngectomy. Of them,15 were accompanied with nutritional risk and 3 without,and the difference was statistically significant（ χ2= 22. 03,P〈 0. 05）. Conclusion Nutritional risk exists in some patients after laryngectomy and is correlated with clinical stage of LC.High prevalence of postoperative complications is correlated with nutritional risk. What＇s more,prevalence of postoperative complication is closely related with nutritional risk in patients after total laryngectomy.