营养风险与腹膜后肿瘤患者住院时间的相关性研究

目的探讨营养风险与腹膜后肿瘤患者住院时间的相关性。方法采用回顾性研究,选取2012年1月至2018年12月四川大学华西医院血管外科新入院腹膜后肿瘤患者60例,采用营养风险筛查表评估患者营养风险,收集患者体质指数、围术期血红蛋白和白蛋白水平、住院天数、术后恶心呕吐发生情况、术后排气、排便时间和首次进食时间。采用单因素分析比较不同患者住院时间,采用多重线性逐步回归分析患者住院时间的影响因素。结果纳入的60例腹膜后肿瘤患者中,40例患者(66.7%)术前存在营养风险,52例患者(86.7%)术后存在营养风险;单因素分析显示,患者术前、术后营养风险(术前P<0.001,术后P=0.043)、术前白蛋白(P=0.019)、术后血红蛋白(P=0.019)、术后白蛋白(P=0.025)水平以及术后恶心呕吐(P=0.001)均会影响患者的住院时间;患者住院时间与围术期营养风险筛查工具评分、术后首次进食时间、术后排气时间和排便时间具有相关性,且相关性强(r=0.759~0.770;P<0.01);多因素分析显示术前营养风险是腹膜后肿瘤患者住院时间的重要预测因素(β=0.399)。结论术前营养风险是腹膜后肿瘤患者住院时间的预测因子。

The nutritional risk and the relation to length of hospital stay among patients with retroperitoneal tumor

Objective This study aimed to explore the relationship between nutrition risks and length of hospital stay in patients with retroperitoneal tumor,and to provide the strategy of clinical nutritional support therapy.Methods 60 patients with retroperitoneal tumor were recruited from a tertiary academic hospital in Chengdu.Nutritional risk was assessed by the European nutritional risk screening scale(NRS 2002)in a retrospective study.In addition,some data on admission and discharge were collected,such as body mass index(BMI),blood albumin,blood hemoglobin,length of hospital stay(LOS),postoperative nausea and vomiting(PONV),exhaust time,defecation time,and time for dieting after surgery.One-way ANOVA were used to compare the length of hospital stay of patients between two groups and three groups,respectively.Multiple linear stepwise regression analysis was used to analyze the influence factors of length of hospital stay of patients.Results Among all patients with retroperitoneal tumor(n=60),the prevalence of nutritional risk before and after operation were 66.7%and 86.7%.Univariate analysis of the factors influencing the LOS of patients showed that patients with nutritional risks were more likely to stay longer in hospital compared to those without(P<0.001,P=0.043).Others factors associated with prolonged LOS were low blood albumin level(P=0.019,P=0.025)during perioperative period,low blood hemoglobin level(P=0.019)after surgery,and PONV(P=0.001).A positive correlation between exhaust time,defecation time,time for dieting after surgery and LOS was observed,and the strength of the association was strong(r=0.759-0.770;P<0.001).Multiple linear stepwise regression analysis indicated that the NRS 2002 of patients with retroperitoneal tumor was significantly predict LOS among the participants(β=0.399).Conclusion Nutritional risk assessed by NRS 2002 on admission predicts LOS for patients with retroperitoneal tumor.A large scaled prospective study is needed to confirm whether supplementing nutritional deficits reduces LOS.