摘要
目的:探讨胃癌(GC)病人术前贫血情况、危险因素及术后并发症,为围手术期的处理提供依据。方法:对某三级医院500例GC病人围手术期的临床资料进行分析,探讨GC病人术前贫血情况、危险因素及术后并发症。结果:500例病人中,贫血病人212例(42.4%),非贫血病人288例(57.6%);贫血组与非贫血组在年龄、体质量指数(BMI)、红细胞计数(RBC)、血红蛋白(Hb)、红细胞分布宽度(RDW-CV)、血清总蛋白(TP)、白蛋白(Alb)、三酰甘油(TG)及总胆固醇(TCH)指标上差异均具有统计学意义(P<0.01);单因素分析显示,年龄≥65岁、合并慢性阻塞性肺疾病、腹部手术史、BMI<18.5 kg/m^(2)、营养风险筛查(NRS2002)≥3分、营养不良、TNM分期(Ⅲ+Ⅳ期)、肿瘤直径>4 cm、分化程度、淋巴结转移、癌胚抗原(CEA)、糖链抗原125(CA125)和糖类抗原199(CA199)水平与GC病人术前贫血有关(P<0.05~P<0.01);logistic回归分析显示,年龄≥65岁,营养不良和肿瘤直径>4 cm是GC病人术前贫血的独立危险因素(P<0.05~P<0.01);与非贫血组相比,贫血组病人术后发热、肺部感染和营养不良并发症明显增加(P<0.05~P<0.01)。结论:胃癌病人术前贫血的危险因素较多,其中年龄≥65岁、营养不良和肿瘤直径>4 cm是GC病人术前贫血的独立危险因素;术前贫血增加了病人术后发热、肺部感染及营养不良并发症的发生率。
Objective:To investigate the anemic condition of patients with gastric cancer(GC)before operation,its risk factors and its correlation with postoperative complications,so as to provide the evidence for perioperative management.Methods:The perioperative clinical data of 500 GC patients in a tertiary hospital were analyzed,and the anemia condition,risk factors and postoperative complications of GC patients were discussed.Results:Among the 500 patients,212 cases(42.4%)were anemia patients and 288 cases(57.6%)were non-anemia patients.The differences of the age,body mass index(BMI),red blood cell count(RBC),hemoglobin(Hb),red blood cell distribution width(RDW-CV),serum total protein(TP),albumin(Alb),triglyceride(TG)and total cholesterol(TCH)between anemia group and non-anemia group were statistically significant(P<0.01).The results of single factor analysis showed that the age≥65 years,combined with chronic obstructive pulmonary disease,history of abdominal surgery,BMI<18.5 kg/m^(2),nutritional risk screening(NRS2002)≥3 scores,malnutrition,TNM stage(Ⅲ+Ⅳ),tumor diameter>4 cm,differentiation degree,lymph node metastasis,and levels of carcinoembryo antigen(CEA),glucose carbohydrate antigen 125(CA125)and carbohydrate antigen 199(CA199)were associated with the preoperative anemia in GC patients(P<0.05 to P<0.01).The results of logistic regression analysis showed that the age≥65 years old,malnutrition and tumor diameter>4 cm were the independent risk factors of preoperative anemia in GC patients(P<0.05 to P<0.01).Compared with the non-anemic group,the complicationa of fever,pulmonary infection and malnutrition significantly increased in the anemia group(P<0.05 to P<0.01).Conclusions:There are many risk factors for preoperative anemia in GC patients.The age≥65 years old,malnutrition and tumor diameter>4 cm are the independent risk factors of preoperative anemia in GC patients.Preoperative anemia increases the incidence of postoperative complications such as fever,pulmonary infection and malnutrition.
作者
马兴好
王家家
江晓阳
张姁
王婷婷
张丽
阮一凡
MA Xinghao;WANG Jiajia;JIANG Xiaoyang;ZHANG Xu;WANG Tingting;ZHANG Li;RUAN Yifan(Department of Clinical Nutrition,Lu′an Hospital Affiliated to Anhui Medical University,Lu′an Anhui 237005,China)
出处
《蚌埠医学院学报》
CAS
2024年第3期348-351,357,共5页
Journal of Bengbu Medical College
基金
安徽医科大学科研基金资助项目(2020xkj230)。
关键词
胃肿瘤
贫血
营养风险筛查
危险因素
并发症
gastric neoplasms
anemia
nutritional risk screening
risk factors
complication
