摘要
目的:同时采用营养风险筛查(NRS)2002和患者参与的主观全面评定(PG-SGA)联合人体成分分析对胃癌胃切除患者术前营养风险筛查和评估的适用性进行评价,寻找术后住院时间延长以及并发症发生率增加的较为准确的预测因子,为临床提供实证依据。方法:使用NRS 2002和PG-SGA对366例胃癌胃切除患者进行术前营养风险筛查和营养评估,并观察人体成分,分析各项指标的差异,分析不同营养风险分级对术后并发症以及住院时间的影响。采用SPSS 23.0进行数据分析,符合正态分布的计量资料多组比较采用方差分析,不符合正态分布的采用Mann-Whitney U检验,计数资料比较采用卡方检验,一致性采用Kappa检验。P<0.05为差异有显著性统计学意义。结果:NRS 2002营养风险筛出率为50.3%,PG-SGA营养风险筛出率为71.3%,其中轻度或可疑营养风险为48.1%,重度营养不良为23.2%。两种筛查方法一致性检验结果中等,Kappa=0.439。存在营养风险患者,术前白蛋白、身体质量指数(BMI)、身体总水分含量、肌肉量、去脂体重、体脂肪、骨骼肌、骨骼肌指数、基础代谢率、上臂周长和上臂肌围均低于无营养风险患者(P<0.05)。通过ROC曲线分析得到NRS 2002预测住院时间延长的评分最佳截止点是3.5分,术前白蛋白预测住院时间延长的最佳截止点是38.6g/L,PG-SAG预测并发症发生的评分最佳截止点是8.5分。结论:NRS 2002、PG-SGA营养风险筛查一致性中等,对于并发症和住院时长的预测存在不同的价值,无法相互替代;NRS 2002≥4分,术前白蛋白低于38.6 g/L患者住院时间更长,PG-SGA≥9分患者并发症发生率更高。
Objective At the same time,nutritional risk screening(NRS)2002 and PG-SGA combined with body composition analysis were used to evaluate the applicability of preoperative nutritional risk screening and assessment in patients with gastric cancer and gastrectomy,so as to find more accurate predictors of longer postoperative hospital stay and increased incidence of complications,so as to provide empirical evidence for clinical practice.Methods NRS 2002 and PG-SGA were used to conduct preoperative nutritional risk screening and nutritional assessment in 366 patients with gastric cancer after gastrectomy.
作者
高延庆
韩菲
朱怀军
宋鹏
陶亮
管文贤
卞晓洁
Gao Yanqing;Han Fei;Zhu Huajun;Song Peng;Tao Liang;Guan Wenxian;Bian Xiaojie(China Pharmaceutical University Nanjing Drum Tower Hospital,Nanjing Jiangsu Province 210008,China;Department of Pharmacy,Nanjing Drum Tower Hospital,The Afiliated Hospital of Nanjing University Medical School,Nanjing Jiangsu Province 210008,China;Department of General Surgery,Nanjing Drum Tower Hospital,The Afiliated Hospital of Nanjing University Medical School,Nanjing Jiangsu Province 210008,China;Subei People's Hospital,Yangzhou Jiangsu Province 225001,China)
出处
《中华普外科手术学杂志（电子版）》
2023年第2期167-171,共5页
Chinese Journal of Operative Procedures of General Surgery(Electronic Edition)
基金
南京市医疗保险研究会基础课题(NJYB2022JC006)
南京大学中国医院改革发展研究院面上课题(NDYG2022015)
南京大学中国医院改革发展研究院培育课题(NDYG2022051)。
关键词
胃肿瘤
胃切除术
营养风险筛查
营养评价
身体成分
Stomach Neoplasms
Nutritional Risk Screening
Gastrectomy
Nutrition Assessment
Body Composition
