术前营养风险筛查在胃癌患者术中的作用及对术后并发症发生率的影响

Effect of nutritional risk screening on gastric cancer surgery and the incidence of postoperative complications

目的:探讨术前营养风险筛查(NRS)在胃癌手术患者中的应用价值及对患者术后并发症发生率的影响。方法:选取2012年8月至2016年2月接受胃癌手术治疗的94例患者作为研究对象,按随机数字表法分为研究组和对照组,每组47例,研究组术前采用NRS2002进行术前NRS,对NRS评分≥3分的患者进行预防性肠内营养,对照组不进行NRS及预防性肠内营养,比较两组手术相关指标、营养指标及并发症发生率情况。结果:研究组经过NRS,其中有22例患者NRS评分≥3分;两组手术时间、术中出血量、手术方式、消化道重建方式比较,差异均无统计学意义(均P>0.05);研究组的术中输血率、肛门排气时间、住院时间均低于对照组(均P<0.05);入院时,两组患者血清白蛋白、IgA水平比较,差异无统计学意义(P>0.05),手术当天清晨、术后第1天、术后第3天,研究组血清白蛋白、IgA水平均高于同时期对照组(均P<0.05);研究组手术总并发症发生率显著低于对照组(P<0.05)。结论:胃癌手术患者术前NRS有利于对具有营养风险的患者进行早期营养补充,有利于患者术后康复及降低术后并发症发生率。

Objective： To explore the application value of nutritional risk screening （NRS）in patients with gastric cancer and its effect on the incidence of postoperative complications. Methods： From August 2012 to February 2016, 94 patients underwent gastric cancer surgery in our hospital were selected and randomly divided into a study group and a control group, with 47 cases in each group. Patients in the study group with NRS score ≥3 received preventive enteral nutrition, but those in the control group did not received NRS and preventive enteral nutrition. The surgical-related indicators, nutritional indicators and the incidence of complications were compared. Results： 22 cases in the study group had NRS score ≥3. There were no significant differences in the operation time, intraoperative blood volume, the modes of operation and digestive tract reconstruction between the two groups （P〉0. 05 ）. The blood transfusion rate, anal exhaust time and hospital days in the study group were lower than those in the control group（P〈0.05）. No statistically significant difference was found in the serum levels of albumin and IgA between the two groups（P〉0. 05）. On the morning of the surgery, 1 day and 3 days after surgery, the albumin and IgA levels in the study group were higher than those in the control group（P〈0.05）. The incidence of complications in the study group was significantly lower than that in the control group （P〈 0. 05）. Conclusion： Preoperative NRS was beneficial for patients with gastric cancer to have early nutritional supplementation. It could promote patients＇ rehabilitation and reduce postoperative complications.