术前格拉斯哥预后评分和控制营养评分对胰十二指肠切除术后严重并发症的预测价值

Predictive value of The Glasgow Prognostic Score and Neutrophil-to-lymphocyte ratio for postoperative complication after pancreaticoduodenectomy

目的探讨术前格拉斯哥预后评分(GPS)、控制营养评分(CONUT)、预后营养指数(PNI)和中性粒细胞/淋巴细胞比值(NLR)对胰头十二指肠切除术病人术后发生严重并发症的预测价值。方法胰十二指肠切除术病人93例。采用受试者工作特征曲线(ROC)、单因素分析及多因素回归分析评估术后严重并发症的影响因素及预测指标。结果术后发生严重并发症(Clavien Dindo并发症分级≥Ⅲ级)22例(23.6%)。单因素分析显示,术前CONUT、GPS、NLR及胰腺质地与胰十二指肠切除术严重并发症的发生密切相关(P<0.05),多因素回归分析提示,GPS评分2分(OR=6.82,P=0.022)、NLR≥3(OR=3.37,P=0.021)、胰腺质地软(OR=6.26,P<0.05)是术后严重并发症的独立危险因素,术后并发症导致住院时间更长。结论GPS高、NLR高是胰十二指肠切除术后严重并发症的独立危险因素,GPS评分和NLR对术后严重并发症的发生具有一定的预测价值。

Objective In order to investigate the predictive significance of preoperative The Glasgow Prognostic Score(GPS),Controlling Nutritional Status(CONUT),Prognostic Nutritional Index(PNI)and Neutrophil-to-lymphocyte ratio(NLR)for Severe complication in the patients who received Pancreatoduodenectomy.Methods 93 patients with pancreaticoduodenectomy.Receiver operating characteristic curve(ROC),univariate analysis and multivariate regression analysis were used to evaluate the influencing factors and predictors of postoperative severe complications.Results The result shows that the incidence of postoperative severe complication(Clavien Dindo classification gradeⅢor higher)was 23.6%(n=22)in this cohort.In the univariate analysis,CONUT score,GPS,NLR and the pancreatic texture were associated with postoperative severe complications(P<0.05).In the multivariate analysis,GPS of 2(OR=6.82,P=0.022),NLR≥3(OR=3.37,P=0.021),pancreatic texture was soft(OR=6.26,P<0.01)were independent risk factors for postoperative severe complications.Conclusion GPS and the NLR were significantly associated with post-operative complications.It would be beneficial to predict the occurrence of serious complications after pancreaticoduodenectomy.