术前不同营养状态对结直肠癌患者根治术后感染风险的影响

Effect of preoperative nutritional status on the risk of infection in patients with colorectal cancer after radical operation

目的探讨术前不同营养状态对结直肠癌患者根治术后感染风险的影响,为临床术前营养风险评估和干预措施的制定提供理论依据。方法选取2015年1月至2018年6月濮阳市安阳地区医院肿瘤外科行结直肠癌手术治疗患者145例为研究对象。根据营养风险评分筛查简表(NRS2002评分)将存在营养风险(NRS2002评分≥3分)的62例患者分为营养风险组,不存在营养风险(NRS2002评分<3分)的83例患者分为非营养风险组。比较两组患者的相关营养指标;比较两组患者医院感染发生率、术后并发症发生率及住院天数。通过单因素分析和多因素回归分析总结结直肠癌根治术患者术后感染的危险因素。结果营养风险组的BMI为(21.62±2.47)kg/m^(2),血红蛋白为(118.75±17.39)g/L、白蛋白为(29.75±5.29)g/L、球蛋白为(24.39±4.76)g/L、铁蛋白为(43.62±12.51)μg/L、肌酐为(48.39±11.63)μmol/L,显著低于非营养风险组;营养风险组医院感染的发生率为14.52%,显著高于非营养风险组;营养风险组的住院天数为(22.03±5.17)d,显著长于非营养风险组,差异均有统计学意义(均P<0.05);多因素回归分析显示,白蛋白水平降低、NRS2002评分升高均是结直肠癌根治术后感染的危险因素(均P<0.05)。结论术前营养状态可显著影响结直肠癌根治术患者术后感染的发生风险。术前针对性提高患者白蛋白水平、降低NRS2002评分有助于降低患者术后感染的发生率。

Objective To investigate the effects of preoperative nutritional status on the risk of infection in patients with colorectal cancer after radical surgery,and to provide a theoretical basis for the preoperative nutritional risk assessment and intervention measures.Methods A total of 145 patients who underwent surgical treatment for colorectal cancer in the department of oncology of this hospital from January 2015 to June 2018 were selected as the study subjects.Sixty-two patients with nutritional risk(NRS2002 score≥3 points)were divided into the nutritional risk group according to the brief screening table for nutritional risk score(NRS2002 score)and no nutritional risk(NRS2002 score<3 points)were divided into the non-nutritional risk group(83 cases).The nutritional indicators of the two groups were compared.The incidence of nosocomial infection,the incidence of postoperative complications and the length of hospital stay were compared between the two groups.The risk factors of postoperative infection in patients undergoing radical resection of colorectal cancer were analyzed by single factor analysis and multivariate regression analysis.Results The BMI of the nutritional risk group was(21.62±2.47)kg/m^(2),hemoglobin was(118.75±17.39)g/L,albumin was(29.75±5.29)g/L,and globulin was(24.39±4.76)g/L,ferritin was(43.62±12.51)μg/L,creatinine was(48.39±11.63)μmol/L,which was significantly lower than non-nutrition risk group(P<0.05).The incidence of nosocomial infection in the nutritional risk group(14.52%)was significantly lower than the non-nutrition risk group(P<0.05).The number of hospitalization days in the nutrition risk group was(22.03±5.17)days significantly longer than the non-nutrition risk group(P<0.05).Multivariate regression analysis showed that decreased albumin level and increased NRS2002 score were risk factors for postoperative infection of colorectal cancer(P<0.05).Conclusions Preoperative nutritional status can significantly affect the risk of postoperative infection in colorectal cancer patients undergoing radical resection of colorectal cancer.Targeted improvement of albumin levels and reduction of NRS2002 scores before surgery can help reduce the incidence of postoperative infection.