腹部外科住院患者肌肉减少症状况及其影响因素分析

Current status and influencing factors of sarcopenia in abdominal surgery inpatients

目的了解腹部外科住院患者肌肉减少症的患病情况,分析其影响因素,为住院患者营养干预提供支持。方法采用横断面研究,调查2019年12月至2021年7月山东省某三甲医院腹部外科符合入组标准的住院患者1131例。记录患者一般资料,测定握力和6米步速时间,行人体成分分析和血清学指标测定,应用NRS2002量表进行营养风险筛查。根据亚洲肌肉减少症工作组(AWGS)2019诊断标准判定是否存在肌肉减少症,计算人群肌肉减少症患病率。将住院患者和其中的手术患者分为肌肉减少症组和非肌肉减少症组,比较住院患者的相关营养指标和手术患者的住院时间和术后住院时间,分析影响肌肉减少症的因素。结果调查显示1131例患者中肌肉减少症患者165例,患病率为14.59%;握力异常305例(26.97%),四肢骨骼肌质量指数(ASMI)异常307例(27.14%),步速异常272例(24.05%)。两组患者在体质量、体质指数、骨骼肌质量、去脂体质量、左上臂肌肉围度、相位角、白蛋白水平、血红蛋白水平、红细胞计数、淋巴细胞计数等方面比较,差异均有统计学意义(均P<0.05)。手术患者中肌肉减少症组的住院时间和术后住院时间明显长于非肌肉减少症组(P<0.05)。年龄、营养风险、黄疸程度是肌肉减少症的独立影响因素(均P<0.05)。结论腹部外科住院患者肌肉减少症的患病率较高,影响手术患者的住院时间和术后住院时间。通过对肌肉减少症的及时筛查和干预,有助于改善患者的临床结局和疾病预后。

Objective To investigate the prevalence of sarcopenia in inpatients with abdominal surgery,and analyze its influencing factors,providing support for nutritional interventions in inpatients.Methods A cross-sectional study was conducted to investigate 1131 inpatients after abdominal surgery who met the inclusion criteria in a tertiary hospital in Shandong Province from December 2019 to July 2021.General information was recorded,grip strength and 6-meter step time were measured,body composition analysis and serological indexes were performed,and nutritional risk screening was performed using the NRS2002 scale.The presence of sarcopenia was determined according to the Asian Working Group for Sarcopenia(AWGS)2019 diagnostic criteria.The patients were divided into sarcopenia group and nonsarcopenia group,while relevant nutritional indicators of all patients,the length of hospital stay,and postoperative hospital stay of surgical patients were compared to screen the influencing factors of sarcopenia.Results A total of 165 patients were found with sarcopenia,with a prevalence of 14.59%.305 cases(26.97%)had abnormal grip strength,307 cases(27.14%)had abnormal skeletal muscle index(ASMI),and 272 cases(24.05%)had abnormal gait speed.There were significant differences in weight,body mass index,skeletal muscle mass,defatted weight,left upper arm muscle circumference,phase angle,albumin,hemoglobin,red blood cells,and lymphocytes between the two groups(all P<0.05).The length of hospital stay and postoperative hospital stay were significantly longer in the sarcopenia group than in the nonsarcopenia group among the surgical patients(P<0.05).Age,nutritional risk,and jaundice were independent influencing factors of sarcopenia(all P<0.05).Conclusions The prevalence of sarcopenia in inpatients of abdominal surgery is at a high level,which affects the length of hospital and postoperative hospital stay of surgical patients.Timely screening and intervention of sarcopenia may help improving the clinical outcome and disease prognosis of patients.