胃肠肿瘤病人术前营养状况筛查及危险因素分析

Preoperative nutritional status screening and risk factors analysis of patients with gastrointestinal tumor

[目的]探讨胃肠道肿瘤病人术前营养状况及营养不良发生的危险因素,为病人围术期的营养支持提供理论依据。[方法]采用前瞻性研究方法,选取2018年6月—2019年5月入住某三级甲等医院胃肠外科接受手术治疗的胃肠道肿瘤病人526例,入院24 h内采用住院病人营养风险筛查评估表(NRS 2002)对其进行营养风险筛查,同时收集病人的年龄、身高、体重、血红蛋白、白蛋白、前白蛋白、中性粒细胞/淋巴细胞比值(NRL),肿瘤发生部位、分化程度等客观临床资料。单因素分析后采用Logistic回归分析病人发生营养不良的危险因素。[结果]526例胃肠肿瘤病人中发生营养不良的有275例,占52.28%,其中以合并进食量减少的病人最高,达62.36%。Logistic回归分析结果显示,年龄、NRL、肿瘤标志物(癌胚抗原≥5 ng/mL)、肿瘤分化程度是胃肠肿瘤病人发生营养不良的独立危险因素。[结论]胃肠肿瘤病人术前营养不良的发生率较高,围术期应积极给予个性化的营养干预,以改善病人的临床结局,提高病人的生命质量。

Objective:To explore the preoperative nutritional status and risk factors related to malnutrition in patients with gastrointestinal tumor,so as to provide theoretical basis for nutritional support during period of perioperation peri-operative period.Methods:By means of prospective study method′totally 526 patients with gastrointestinal tumor,who were admitted to gastrointestinal surgery of a tertiary garde A hospital from June 2018 to May 2019 for surgical treatment were selected.And nutrition risk screening 2002 was used to screen their nutritional risk within 24h after admission.Meanwhile,objective clinical data,such as the age,height,weight,hemoglobin,albumin,pre-albumin,neutrophil-to-lymphocyte ratio(NRL),occurrence site and differentiation degree of tumor,and so on,were collected.After single-factor analysis,risk factors related to malnutrition were further analyzed by Logistic regression analysis.Results:There were 275 cases with malnutrition among 526 patients with gastrointestinal tumor,with the incidence of 52.28%.Among patients with malnutrition,patients with complication of decreased food intake were the most common,with the incidence of 62.36%.Logistic regression analysis showed that the independent risk factors of gastrointestinal tumor patients with malnutrition were age,NRL,tumor marker(CEA≥5 ng/mL),the differentiation of tumor.Conclusions:The incidence of preoperative malnutrition was high in patients with gastrointestinal tumor,In view of this,personalized nutritional intervention should be actively given,during period of penoperation so as to improve the clinical outcome and quality of life of patients with gastrointestinal tumor.