NRS2002与血清前白蛋白在肝胆管结石患者预后评估中的应用价值

The Application Value of NRS2002 and Serum Prealbumin in the Prognostic Evaluation of Patients with Hepatolithiasis

目的分析营养风险筛查量表(NRS2002)与血清前白蛋白(PA)联合应用于肝胆管结石术后患者预后评估的价值。方法方便选择2017年1月—2020年6月该院收治的78例肝胆管结石患者,术前均采用PA和NRS2002对其进行营养风险筛查,分为有营养风险组(评分≥3分,PA<200 mg/L;n=30),无营养风险组(评分<3分,PA≥200 mg/L;n=28),可疑营养风险组(其中一项异常;n=20),分析比较3组手术指标、术后肝功能、胃肠道恢复、术后并发症及住院时间。结果有营养风险组手术时间(51.45±6.71)min,术中出血量(85.42±9.56)mL,与无风险组和可疑风险组比较,差异有统计学意义(F=45.958、32.153,P<0.05)。3组术后谷丙转氨酶、谷草转氨酶、谷草转氨酶水平比较,差异有统计学意义(P<0.05)。有营养风险组术后肛门排气时间(22.69±4.19)h、首次进食时间(23.45±3.46)h、排便时间(66.34±7.21)h,均较无风险组和可疑风险组长,差异有统计学意义(P<0.05)。有营养风险组术后并发症发生率为33.33%,术后住院时间(15.42±4.67)d,与另外两组比较,差异有统计学意义(P<0.05)。结论NRS2002联合血清PA能对肝胆管结石患者提供术前营养评估,为患者术后预后情况预测及评估提供重要指导。

Objective To analyze the combined application of Nutritional Risk Screening Scale(NRS2002)and serum prealbumin(PA)in prognosis evaluation of patients after hepatolithiasis.Methods Selected conveniently 78 patients with hepatolithiasis admitted to the hospital from January 2017 to June 2020,and they were screened for nutritional risk with PA and NRS2002 before surgery,divided into nutritional risk group(score≥3 points,PA<200 mg/L;n=30),no nutritional risk group(score<3 points,PA≥200 mg/L;n=28),suspicious nutrition risk group(one of which was abnormal;n=20),analysis and comparison of three groups of surgical indicators,postoperative liver function,gastrointestinal recovery,postoperative complications and hospital stay.Results The operation time of the nutritional risk group was(51.45±6.71)min,and the intraoperative blood loss was(85.42±9.56)mL.Compared with the non-risk group and the suspicious risk group,the difference was statistically significant(t=45.958,32.153,P<0.05).Comparison of the levels of alanine aminotransferase,aspartate aminotransferase,and aspartate aminotransferase in the three groups after surgery showed,the difference was statistically significant(P<0.05).The postoperative anal exhaust time(22.69±4.19)h,the first meal time(23.45±3.46)h,and the defecation time(66.34±7.21)h in the nutrition risk group were longer than those in the no-risk group and the suspicious-risk group,the difference was statistically significant(P<0.05).The incidence of postoperative complications in the nutritional risk group was 33.33%,and the postoperative hospital stay was(15.42±4.67)d,compared with the other two groups,the difference was statistically significant(P<0.05).Conclusion NRS2002 combined with serum PA can provide preoperative nutritional assessment for patients with hepatolithiasis,and provide important guidance for prognosis prediction and evaluation of patients after surgery.