预后营养指数对腹腔镜直肠癌根治术后并发症的预测价值

Predictive value of prognostic nutritional index for postoperative complications of laparoscopic radical surgery in rectal cancer

目的:探讨预后营养指数(PNI)对腹腔镜直肠癌根治术后并发症的预测价值。方法:回顾性分析2016年1月至2020年5月在我院普外科行腹腔镜直肠癌根治术的220例直肠癌患者的临床资料。根据术后有无发生并发症分为并发症组(n=63例)和无并发症组(n=157例)。比较两组临床病理特征;采用多因素Logistic回归分析影响腹腔镜直肠癌根治术后并发症的危险因素。结果:220例接受腹腔镜直肠癌根治术患者中63例(28.64%)术后发生了并发症;两组年龄、性别、BMI、术前有合并疾病、肿瘤位置、TNM分期、肿瘤直径、手术时间、PNI组间比较差异有统计学意义(P<0.05);多因素Logistic回归分析显示,年龄、性别、术前合并疾病、肿瘤位置、手术时间和PNI是腹腔镜直肠癌根治术后并发症发生的独立危险因素(P<0.05)。结论:术前低PNI是腹腔镜直肠癌根治术后并发症的独立危险因素,临床上可通过PNI评估患者术前营养状况,必要时术前予以营养支持治疗。

Objective:To explore the predictive value of prognostic nutritional index(PNI)for postoperative complications of laparoscopic radical resection of rectal cancer.Methods:The clinical data of 220 patients with rectal cancer who underwent laparoscopic radical resection of rectal cancer in general surgery department of Traditional Chinese Medicine Hospital of Yibin from January 2016 to May 2020 were retrospectively analyzed.The patients were divided into complication group(n=63 cases)and non-complication group(n=157 cases)according to postoperative complications.The clinicopathological features of the two groups were compared.Multivariate Logistic regression analysis was used to analyze the risk factors of complications after laparoscopic radical resection of rectal cancer.Results:There were 220 patients with rectal cancer performed by the laparoscopic radical resection.The postoperative complications occurred in the 63(28.64%)patients.There were significant differences in age,gender,BMI,preoperative complications,tumor location,TNM stage,tumor diameter,operation time and PNI between the two groups(P<0.05).Multivariate Logistic regression analysis showed that age,gender,preoperative complications,tumor location,operation time and PNI were independent risk factors for postoperative complications(P<0.05).Conclusion:Preoperative low PNI is an independent risk factor for postoperative complications of laparoscopic radical resection of rectal cancer.Preoperative nutritional status of patients can be evaluated by PNI clinically,and nutritional support treatment can be given if necessary.