营养风险对结肠癌患者腹腔镜手术后短期效果的影响

Impact of nutritional risk on short term outcomes of laparoscopic surgery in patients with colon cancer

目的探究营养风险对结肠癌患者腹腔镜手术后短期效果的影响。方法回顾性分析2015年1月-2018年1月该院收治的60例结肠癌患者的临床资料,所有患者均于该院顺利完成腹腔镜辅助结肠癌根治术治疗。依据患者是否存在营养风险将其分为风险组(n=17,营养风险评分≥3分)和无风险组(n=43,营养风险评分<3分)。比较两组患者的临床疗效、并发症和免疫功能情况。结果风险组与非风险组患者的临床总有效率分别为76.48%和86.06%,风险组低于无风险组;风险组和无风险组患者的并发症总发生率分别为23.52%和13.93%,风险组高于无风险组,差异有统计学意义(P<0.05)。两组患者的CD8^+比例差异无统计学意义(P>0.05)。风险组患者的CD3^+、CD4^+比例及CD4^+/CD8^+比值均低于无风险组患者,CD4^+CD25^+比例高于无风险组患者,差异有统计学意义(P<0.05)。结论营养风险会降低结肠癌患者免疫功能,增大并发症发生率,影响临床疗效,因而临床中应积极给予术前营养支持,以改善临床疗效。

Objective To investigate the impact of nutritional risk on the short-term outcomes of laparoscopicsurgery in patients with colon cancer. Methods The clinical data of 60 patients with colon cancer from January2015 to January 2018 were retrospectively analyzed. All the patients were successfully treated with laparoscopicassistedradical resection. The patients were divided into the risk group （n = 17, nutrition risk score ≥ 3） and risk-freegroup （n = 43, nutrition risk score 〈3） according to whether the patients had nutritional risk. The clinical efficacy,complications and immune function were compared between the two groups. Results The total effective rates of thepatients in the risk group and non-risk group were 76.48% and 86.06%, respectively, and those in the risk group werelower than those in the non-risk group. The total complication rates in the risk group and the risk-free group were23.52% and 13.93% The risk group was higher than the risk-free group, the difference was statistically significant（P 〈 0.05）. There was no significant difference in the proportion of CD8＋ between the two groups （P 〉 0.05）. Patientsin the risk group had lower rates of CD3^＋, CD4^＋ and CD4^＋/CD8^＋ than those in the non-at risk group, with a higherproportion of CD4^＋ CD25^＋ than that in the non-risk group （P 〈 0.05）. Conclusion Nutritional risk will reduce theimmune function of colon cancer patients, increase the incidence of complications, affecting clinical efficacy, andtherefore should be actively given in clinical nutrition support before surgery to improve clinical efficacy.