肌肉减少症与老年食管癌患者胸腔镜切除术后并发症的相关性研究

Correlation Between Sarcopenia and Postoperative Complications in Elderly Patients Underwent Thoracoscopy Esophagectomy

目的探讨肌肉减少症与老年食管癌患者腹腔镜切除术后并发症的相关性。方法选取82例接受胸腔镜切除术的老年食管癌患者作为观察对象;收集所有患者的临床资料;CT测量SMI判定是否为肌肉减少症;多因素Logistic回归分析影响老年食管癌患者胸腔镜切除术后并发症发生的因素。结果82例接受胸腔镜食管癌切除术的老年食管癌患者,其中34例(41.46%)被确诊为肌肉减少症,48例(58.54%)为非肌肉减少症;肌肉减少症者BMI显著低于非肌肉减少症者(P<0.05),其余基线资料比较差异无统计学意义(P>0.05);82例患者中,其中37例(45.12%)发生并发症,45例(54.88%)没有发生并发症;发生并发症与未发生并发症者ASA分级、肌肉减少症比例比较差异均有统计学意义(P<0.05);多因素Logistic回归分析显示,肌肉减少症(OR=3.719,95%CI:1.301~10.634)是影响老年食管癌患者胸腔镜切除术后并发症发生的危险因素(P<0.05)。结论肌肉减少症是影响老年食管癌患者胸腔镜切除术后并发症发生的独立危险因素,手术患者应尽早进行诊断,及时干预、给予营养支持,从而降低术后并发症的发生风险。

Objective To investigate the correlation between sarcopenia and complications after laparoscopic resection in elderly patients with esophageal cancer.Methods 82 elderly patients with esophageal cancer who underwent thoracoscopy esophagectomy were selected as observation objects;clinical data of all patients were collected;CT was applied to measure SMI to determine whether the patient had Sarcopenia;multivariate Logistic regression analysis of the factors affecting the incidence of postoperative complications in elderly patients with esophageal cancer after thoracoscopic resection.Results A total of 82 elderly patients with esophageal cancer who underwent thoracoscopy esophagectomy were included in this study,34 patients(41.46%)were diagnosed as Sarcopenia,48 patients(58.54%)were non Sarcopenia;BMI of Sarcopenia group was obviously lower than that of non Sarcopenia group(P<0.05),and there was no obvious difference in other baseline data(P>0.05);among 82 patients,37(45.12%)had complications,while 45(54.88%)had no complications;there were obvious differences in ASA grading and the proportion of patients with Sarcopenia between those with complications and those without complications(P<0.05);multivariate logistic regression analysis showed that Sarcopenia(OR=3.719,95%CI:1.301~10.634)was a risk factor for postoperative complications in elderly patients undergoing thoracoscopy esophagectomy(P<0.05).Conclusion Sarcopenia is an independent risk factor for complications after thoracoscopic resection in elderly patients with esophageal cancer.Surgical patients should be diagnosed as early as possible,timely intervention and nutritional support are provided to reduce the risk of postoperative complications.