口腔癌患者术前营养风险指数与术后疼痛的相关性分析

Association of preoperative nutritional risk index with postoperative pain outcomes in patients undergoing oral surgery

目的:分析口腔癌患者术前营养状态与术后镇痛药需求之间的关系。方法:回顾性纳入行口腔癌根治术的593例患者。收集人口学特征、合并症、术前检验结果、手术特点、术中药物的使用以及术后镇痛药的使用等资料。以营养风险指数(nutritional risk index,NRI)来评估患者术前的营养状态。使用Logistic回归对术前NRI与术后镇痛药需求的关系进行分析。结果:纳入患者术前NRI的中位值为94.6,355例患者(59.9%)术前有中重度营养不良风险(NRI≤97.5)。进行多因素Logistic回归分析,分别调整不同的混杂因素来分析口腔癌患者术前NRI与术后镇痛药需求的关系。当NRI以连续变量纳入分析时,患者术后镇痛药需求随NRI的升高而降低(P<0.05);当NRI以分类变量纳入分析时,NRI≤97.5的患者术后镇痛药需求较NRI>97.5的患者高(P<0.05)。结论:术前营养不良在口腔癌患者中比较常见,是患者术后镇痛药需求增加的危险因素。

Objective:To examine the correlation between preoperative nutritional status and postoperative analgesic needs in patients with oral cancer.Methods:We conducted a retrospective study.A total of 593 patients who underwent radical resection for oral cancer were included.Demographic information,comorbidities,preoperative blood test results,surgical characteristics,intraoperative medication use,and postoperative analgesic use were collected.The nutritional risk index(NRI)was calculated as an indicator of the patient's nutritional status.Logistic regression analysis was employed to investigate the association between the preoperative NRI score and postoperative analgesic needs.Results:The median preoperative NRI of the included patients was 94.6.Totally 355 patients(59.9%)classified as being at moderate to severe risk of malnutrition(NRI≤97.5).Through multivariate logistic regression analysis by adjusting for various confounding factors,we examine the relationship between preoperative NRI and postoperative analgesic needs in oral cancer patients.When including NRI as a continuous variable in the models,an increase in NRI was associated with a decrease in postoperative analgesic needs among patients(P<0.05).When NRI was included as a categorical variable,patients with an NRI≤97.5 required less postoperative analgesics compared to those with an NRI97.5(P<0.05).Conclusion:Our findings suggest that preoperative malnutrition is prevalent among oral cancer patients and poses a risk for increased postoperative analgesic needs.