术前营养风险筛查对胃癌患者术后并发症、生活质量及预后的影响研究

Effect of preoperative nutritional risk screening on postoperative complications,quality of life and prognosis of gastric cancer patients.

目的分析术前营养风险筛查对胃癌患者术后并发症、生活质量、预后的影响。方法前瞻性选取应急总医院2017年11月至2019年11月收治的胃癌切除术患者116例,利用营养风险筛查2002(NRS2002)评估患者的营养风险,并据此分成营养风险组、无营养风险组。比较2组术后并发症发生率,经癌症患者生活质量测定量表(QLQ-C30)评估患者术前、术后3个月的生活质量;随访1年,分析术前营养风险对患者术后总生存率的影响。结果在116例患者中,营养风险发生率为47.41%。营养风险组胃排空障碍与总并发症发生率分别为16.36%、20.00%,高于无营养风险组(4.92%、6.56%),差异均有统计学意义(P<0.05)。营养风险组术后3个月的总体生活质量、社会功能、躯体功能、情绪功能评分低于无营养风险组,营养风险组术后3个月的睡眠障碍、食欲减退、便秘、腹泻评分高于无营养风险组,差异均有统计学意义(P<0.05)。营养风险组随访1年的总生存率为89.09%,与无营养风险组的96.72%比较,差异无统计学意义(P>0.05)。结论术前营养风险筛查能了解患者的基础营养状况,其中有营养风险的患者术后并发症风险增高,生活质量下降,但其对术后1年的预后未见明显影响。

Objective To analyze the influence of preoperative nutritional risk screening on postoperative complications,quality of life and prognosis of gastric cancer patients.Methods A total of 116 patients undergoing gastrectomy in Emergency General Hospital from November 2017 to November 2019 were prospectively selected,and assessed the nutritional risk of the patients using the Nutrition Risk Screening 2002(NRS2002),and divided them into nutritional risk groups,no nutritional risk group.The incidence of postoperative complications was compared between the two groups.The quality of life of the patients before and 3 months after the operation was assessed by the QLQ-C30.The follow-up was 1 year,and the nutritional risk before and after the operation was analyzed.The impact of overall survival.Results Among 116 patients,the nutritional risk rate was 47.41%.The incidence of gastric emptying disorder and total complications in the nutritional risk group were 16.36%and 20.00%,respectively,which were higher than 4.92%and 6.56%in the no nutritional risk group,the differences were statistically significant(P<0.05).The overall quality of life,social function,physical function,and emotional function scores of the nutritional risk group were lower than those of the no nutritional risk group at 3 months after surgery,the scores of sleep disturbance,loss of appetite,constipation,and diarrhea in the nutritional risk group were higher than those in the no nutritional risk group,the differences were statistically significant(P<0.05).The 1-year overall survival rate of the nutritional risk group was 89.09%,there was no difference compared with 96.72%of the no nutritional risk group(P>0.05).Conclusion Preoperative nutritional risk screening can understand the basic nutritional status of patients.Among them,patients with nutritional risk have an increased risk of postoperative complications and a decreased quality of life,but it has no significant impact on the prognosis of 1 year after surgery.