360例胃肠道肿瘤患者术前合并肌肉减少症的现状及影响因素分析

Current Status of patients with gastrointestinal tumor complicated with preoperative sarcopenia and it influencing factors:a 360-case study

目的探讨胃肠道肿瘤患者术前肌肉减少症的发生情况,分析其影响因素。方法采用便利抽样的方法,选择2021年3月—2022年1月于烟台市某三级甲等医院胃肠外科住院的360例胃肠道肿瘤术前患者为研究对象。研究者对研究对象进行人体成分分析、肌力和躯体功能的检查,采用一般资料调查表、Barthel指数评定量表、国际体力活动问卷短卷对其进行评估和调查并测量患者的上臂围和腰围,采用二分类Logistic回归分析胃肠道肿瘤患者术前发生肌肉减少症的影响因素。结果360例胃肠道肿瘤患者,术前81例发生肌肉减少症,发生率为22.5%。二分类Logistic回归分析显示,饮酒史(OR=3.181,P=0.027)、肿瘤分期(OR=6.402,P<0.001)、合并糖尿病(OR=6.156,P<0.001)、日常生活能力(OR=5.297,P=0.003)是肌肉减少症的危险因素,体质量指数(OR=0.751,P<0.001)、体力活动水平(OR=0.101,P<0.001;OR=0.078,P=0.002)是肌肉减少症的保护性因素。结论胃肠道肿瘤患者术前肌肉减少症的发生率较高,饮酒史、合并糖尿病、肿瘤分期、体质量指数、日常生活能力、体力活动水平是胃肠道肿瘤术前患者肌少症的重要预测因素,建议术前制定适合胃肠道肿瘤患者的营养和运动等干预措施,降低其肌肉减少症的发生风险。

Objective To investigate the occurrence of preoperative sarcopenia in patients with gastrointestinal neoplasms and to analyze its influencing factors.Methods Convenience sampling was used to select 360 patients with gastrointestinal tumors before surgery who were hospitalized in the Gastrointestinal Surgery Department of a tertiary grade-A hospital in Yantai City from March 2021 to January 2022.Body composition analysis,muscle strength and physical function examination of the subjects were performed.The general information questionnaire,Barthel Index Rating Scale and International Physical Activity Questionnaire were used to evaluate and investigate the subjects.The upper arm circumference and waist circumference of the patients were measured.Binary logistic regression was used to analyze the influencing factors of preoperative sarcopenia in patients with gastrointestinal tumors.Results Among 360 patients with gastrointestinal tumors before operation,81 patients with sarcopenia,with an incidence of 22.5%.Binary Logistic regression analysis showed that drinking history(OR=3.181,P=0.027),tumor stage(OR=6.402,P<0.001),concurrent diabetes mellitus(OR=6.156,P<0.001),and daily living ability(OR=5.297,P=0.003)were risk factors for sarcopenia;body mass index(OR=0.751,P<0.001)and physical activity level(OR=0.101,P<0.001;OR=0.078,P=0.002)were protective factors for sarcopenia.Conclusion There is high incidence of preoperative sarcopenia in patients with gastrointestinal tumors.Drinking history,concurrent diabetes mellitus,tumor stage,body mass index,daily living ability,and physical activity level are important predictors of sarcopenia in patients with gastrointestinal tumors before operation.It is recommended to develop nutrition and exercise intervention measures suitable for patients with gastrointestinal tumors before operation to reduce the risk of sarcopenia.