肌少症对原发性肝癌肝切除术后并发症的评估价值

Applied value of sarcopenia evaluating short-term outcomes in patients with primary liver cancer following resection

目的探讨肌少症(SAR)对原发性肝癌肝切除术后并发症的评估价值。方法前瞻性研究2014年6月至2017年12月行肝切除术的原发性肝癌病人85例,SAR的诊断由CT计算的腰肌体积评定。并发症分级采用Clavien-Dindo分级系统,相关危险因素采用单变量和多变量分析。结果本组SAR病人为11例(12.9%),SAR发病率与高龄、低体质量指数、高NRS2002营养风险、低血清白蛋白显著相关。SAR病人有更高的术后并发症发病率和更长的住院时间。单因素分析显示,术后并发症的影响因素包括SAR(P<0.001)、营养风险评分(NRS 2002,P=0.009)、年龄(>75岁,P=0.014)、低蛋白血症(P=0.039)和糖尿病(P=0.014)。多因素分析显示,SAR(P<0.001)和糖尿病(P=0.006)是独立的术后并发症预测因素。结论 SAR(经CT对腰肌体积诊断)是预测原发性肝癌肝切除术后并发症的独立危险因素。

Objective To evaluate the applied value of sarcopenia（SAR）in the evaluation of complications after hepatectomy for primary liver cancer.Methods We conducted a prospective study on 85 patients with primary liver cancer who underwent hepatectomy from June 2014 to December 2017.The diagnosis of SAR was made according to the volume of lumbar muscles calculated by perioperative abdominal CT scan.The postoperative complications were classified by Clavien-Dindo classification system.Factors contributing to postoperative complications were analyzed by univariate and multivariate analysis.Results SAR was present in 11 of 85 patients（12.9%）,and SAR was significantly associated with age,lower body mass index,high nutritional risk（NRS2002）,and lower preoperative serum albumin and hemoglobin.SAR patients had a higher risk of postoperative complications.Multivariable analysis revealed that SAR（P〈0.001）and diabetes（P=0.006）were independent factors predicting the postoperative complications.Conclusions SAR is an independent predictor of postoperative complications following hepatectomy for primary liver tumors.