术前控制营养状态评分评估胰十二指肠切除术后病人短期预后的临床价值

Clinical value of preoperative controlling nutritional status score in evaluating short-term prognosis after pancreaticoduodenectomy

目的探讨术前控制营养状态(controlling nutritional status,CONUT)评分在评估胰十二指肠切除术后病人短期预后中的临床价值。方法回顾性分析武汉大学人民医院2017年4月至2021年4月行胰十二指肠切除术的86例胰头或壶腹周围恶性肿瘤病人的临床资料。根据受试者工作特征(ROC)曲线将所有病人分为高CONUT评分组(CONUT评分≥4分,26例)和低CONUT评分组(CONUT评分<4分,60例),分析CONUT评分与胰十二指肠切除病人短期预后之间的关系。结果与低CONUT评分组病人比较,高CONUT评分组病人术后发生严重并发症(Clavien-DindoⅢ级及以上)的概率显著增加(30.7%比10.0%,P=0.017),术后住院时间显著延长(Z=6.682,P=0.01),住院期间死亡率显著增加(11.5%比1.6%,P=0.046)。结论术前CONUT评分是评估行胰十二指肠切除术后病人短期预后的有效指标,术前高CONUT评分往往提示病人术后更容易出现严重并发症,病人住院时间更长及住院期间死亡率更高。

Objective To evaluate the short-term prognostic value of preoperative controlling nutritional status(CONUT)scores in patients after pancreaticoduodenectomy(PD).Methods From April 2017 to April 2021,clinical data were retrospectively analyzed for 86 patients undergoing PD.Based upon the receiver operating characteristic curve(ROC),they were divided into high CONUT(≥4 points,n=26)and low CONUT(<4 points,n=60).The relationship was evaluated between CONUT score and short-term patient prognosis after PD.Results Compared with patients with low CONUT score,patients with high CONUT score had a significantly higher probability of severe postoperative complications(Clavien-DindoⅢand above:30.7%vs.10.0%,P=0.017),postoperative hospital stay became markedly prolonged(Z=6.682,P=0.01)and in-hospital mortality was significantly extended(11.5%vs.1.6%,P=0.046).Conclusion Preoperative CONUT score is an effective indicator for evaluating the short-term patient prognosis after PD.High preoperative CONUT score often indicates a higher probability of serious postoperative complications,longer hospitalization stay and higher mortality during hospitalization.