胰十二指肠切除术后营养不良的危险因素

目的 研究胰十二指肠切除术（pancreaticoduodenectomy,PD）术后营养不良的危险因素。方法 选取2019年3月至2020年10月海军军医大学第二附属医院行PD治疗的122例患者进行横断面研究,根据营养风险筛查量表（nutritional risk screening,NRS） （2002）将122例患者分为营养不良风险组（n=70）和对照组（无营养不良风险,n=52）。分析两组患者的临床资料,并采用单因素和多因素Logistic分析得出术后营养不良的相关危险因素。结果 老年患者（≥60岁）、术前胆道引流、术后感染、术后焦虑评分SAS≥50分、术后抑郁评分SDS≥50分、术前血清白蛋白（ALB）≤32.5 g/L、术前血清视黄醇蛋白（RBP）≤42.5 mg/L、术前血清转铁蛋白（TRF）≤2.45 g/L是导致PD术后营养不良的独立危险因素（P<0.05）。结论 胰十二指肠切除术后患者营养不良的危险因素较多,应根据不同危险因素采取对应的预防措施,减少术后营养不良发生,促进患者术后康复。

Risk factors for malnutrition after pancreatoduodenectomy

Objective To investigate the risk factors for malnutrition after pancreaticoduodenectomy (PD). Methods A total of 122 patients who underwent PD in the Second Affiliated Hospital of Navy Medical University between Mar. 2019 and Oct. 2020 were selected for cross-sectional study. According to NRS 2002, 122 patients were divided into the group with malnutrition risk (n=70) and the control group without malnutrition risk (n=52). Logistic univariate and multivariate analyses were applied to acquire, the independent risk factors for malnutrition after PD. Results Elderly patients (≥60 years), preoperative biliary drainage, postoperative infection, postoperative anxiety score SAS≥50 points, postoperative depression score SDS≥50 points, preoperative level of ALB≤32.5 g/L, preoperative level of RBP≤42.5 mg/L, preoperative level of TRF≤2.45 g/L,were independent risk factors for malnutrition after PD (P<0.05). Conclusion Prophylactic measures should be taken according to different risk factors for malnutrition after PD, to reduce the occurrence of postoperative malnutrition in clinical practice, and to promote postoperative recovery of patients with PD.