主观全面评估营养筛查对结肠癌术后并发症的预测

Predictive value of scored patient-generated subjective global assessment for postoperative complications of colorectal cancer

目的探讨主观全面评估(PG-SGA)营养风险筛查评分在结肠癌围术期中的应用及对术后并发症发生情况的影响。方法回顾性选取2015年10月至2016年12月间我院普外科收治行择期手术的110例结肠癌患者,按照主观全面评定法(PG-SGA)进行术前营养风险筛查,统计术后并发症发生率,同时分析其高危因素。结果根据PG-SGA评分,存在营养风险41例(PG-SGA≥4分)和无营养风险(PG-SGA<4分)69例;共31例(28.18%)出现术后并发症,PG-SGA评分<4分组术后并发症为15例(21.73%),明显低于PG-SGA评分≥4组的并发症16例(39.02%),差异有统计学意义(P<0.05);PG-SGA评分≥4组中营养支持者与未营养支持者相比,术后并发症发生率明显低(29.17%vs.52.94%,P<0.05)差异有统计学意义。Logistic多因素风险回归分析结果显示,高龄、ASA分级、分化程度和PG-SGA评分是结肠癌术后并发症的独立危险因素(均P<0.05)。结论术前PG-SGA营养风险筛查评分,可有效预测结肠癌术后并发症的发生率,并指导围手术期营养支持。

Objective To evaluate the predictive value of scored patient-generated subjective global assess-ment(PG-SGA)for patients with colorectal carcinoma.Methods Data of 110 colorectal carcinoma patients treated by radical resection were collected prospectively.Preoperative nutritional status was evaluated by PG-SGA.Postopera-tive complication rates and risk factors were recorded and analyzed.Results There were 41 cases with nutritional risk(PG-SGA Score≥4)and 69 cases without(PG-SGA Score<4).There were 31 cases(28.18%)with postopera-tive complications.The morbidities of postoperative complications in patients with or without malnutrition risk were 16(39.02%)and 15(21.73%)respectively,which indicated significantly statistical differences(P<0.05).The complication rate of patients with preoperative nutrition support was significantly lower than that without in group of PG-SGA score≥4(29.17%vs.52.94%,P<0.05).Logistic regression analysis showed that advanced age,ASA grade,differentiation,and PG-SGA score were independent risk factors(P<0.05).Conclusion PG-SGA as a nu-trition screening tool could evaluate postoperative complications for colorectal carcinoma patients and provide guid-ance for perioperative nutrition support.