老年食管鳞癌术后患者肌少症发生临床特征及相关因素分析

Analysis of Clinical Characteristics and Factors Associated with the Occurrence of Sarcopenia in Elderly Patients after Esophageal Squamous Carcinoma Surgery

目的:分析老年食管鳞癌术后患者肌少症(SA)发生临床特征及相关因素。方法:回顾性分析医院于2018年3月至2021年10月收治的120例老年食管鳞癌患者的临床资料,基于计算机L3椎体水平横断面骨骼肌横截面及L3骨骼肌质量指数(L3 SMI),根据国际SA诊断标准(男性:L3 SMI≤40.8cm^(2)/m^(2),女性:L3 SMI≤34.9cm^(2)/m^(2))将所有患者分为SA组(n=49)和non-SA组(n=71);记录两组患者术后临床特征,包括一般资料、手术指标、生化指标等;采用Logistic回归分析SA发生的影响因素。结果:两组一般资料:年龄、机体功能状态(KPS)评分、体质指数(BMI)、血清前白蛋白(PA)比较差异有统计学意义(P<0.05),其余临床指标比较差异无统计学意义(P>0.05);Logistic回归分析显示:年龄、KPS评分、BMI为老年食管癌术后患者SA发生的影响因素。结论:老年食管癌患者术后SA发生与患者年龄、BMI等多种因素相关,临床应重视SA发生的相关因素,及时采取针对性干预措施以降低术后SA发生率。

Objective:To analyze the clinical characteristics and related factors of sarcopenia(SA)in elderly patients after esophageal squamous carcinoma surgery.Methods:A retrospective analysis was performed on the clinical data of 120 elderly patients with esophageal squamous carcinoma admitted to the hospital between March 2018 and October 2021.According to L3 skeletal muscle index(L3 SMI)and international diagnostic criteria for SA(male:L3 SMI≤40.8cm^(2)/m^(2),female:L3 SMI≤34.9cm^(2)/m^(2)),the patients were divided into SA group(n=49)and non-SA group(n=71).Postoperative clinical characteristics of the two groups were recorded,and the influencing factors of SA were screened by logistic regression analysis.Results:There were statistically significant differences in general data[age,Karnofsky Performance Scale(KPS)score,body mass index(BMI),and serum prealbumin(PA)]between the two groups(P<0.05),but there was no statistically significant difference in the other clinical indexes(P>0.05).Logistic regression analysis showed that age,KPS score and BMI were influencing factors of SA.Conclusion:The occurrence of SA in elderly patients after esophageal squamous carcinoma surgery is related to multiple factors.Clinically,attention should be paid to the related factors of SA,timely and targeted intervention measures should be taken to reduce the incidence of postoperative SA.