老年营养风险指数在老年胃肠肿瘤围术期的应用

目的:初步研究老年营养风险指数在老年胃肠肿瘤病人围术期的应用价值。方法:应用老年营养风险指数和营养风险筛查2002评估接受胃肠肿瘤手术老年病人(≥60岁)的营养风险。比较存在老年营养风险或营养风险的病人与无老年营养风险或无营养风险病人术后并发症发生及术后住院时间的差异。观察术前营养支持对两组术后并发症发生及术后住院时间的影响。结果:共纳入150例老年病人。老年营养风险发生率为60.00%(90/150),营养风险发生率为40.67%(61/150),Kappa值为0.062(P=0.415)。有老年营养风险者术后并发症发生率和术后住院时间分别为13.33%(12/90)和(10.37±4.66)d,与无风险者的23.33%(14/60)和(11.80±6.36)d相比,差异无统计学意义(P>0.05)。术前营养支持的老年营养风险病人术后并发症发生率和术后住院时间分别为6.38%(3/47)和(8.85±2.58)d,明显低于未接受营养支持者的20.93%(9/43)和(12.02±5.78)d(P<0.05)。有营养风险者术后并发症发生率和术后住院时间分别为13.11%(8/61)和(10.56±4.58)d,与无营养风险者的20.22%(18/89)和(11.20±5.95)d相比,差异无统计学意义(P>0.05)。术前营养支持的营养风险病人术后并发症发生率和术后住院时间分别为10.26%(4/39)和(10.03±4.94)d,与未接受营养支持者的18.19%(4/22)和(11.50±3.78)d相比,差异无统计学意义。结论:老年营养风险指数可用于老年胃肠肿瘤术前营养筛查,并作为术前营养支持的参考依据。

Perioperative application of geriatric nutritional risk index in senile patients with gastrointestinal tumors

Objective To study the value of perioperative application of geriatric nutritional risk index(GNRI)in elderly patients with gastrointestinal tumor.Methods GNRI or nutritional risk screening 2002(NRS 2002)was used to evaluate the nutritional risk in elderly patients(≥60 years old)with gastrointestinal tumor surgery.Both operative complications and postoperative hospital stay in elderly patients with geriatric nutritional risk or nutritional risk were compared with those without geriatric nutritional risk or nutritional risk.The effect of preoperative nutritional support on operative compli-cations and postoperative hospital stay in two groups was studied.Results A total of 150 elderly patients were enrolled.Geriatric nutritional risk and nutritional risk in the patients was predicted at 60.00%(90/150)and 40.67%(61/150)respec-tively.The Kappa value was 0.062(P=0.415).Operative complication rate in the patients with geriatric nutritional risk was13.33%(12/90)and postoperative hospital stay(10.37±4.66)days without significant difference(P>0.05)when compared with those23.33%(14/60),(11.80±6.36)days]in the patients without geriatric nutritional risk.Preoperative nutritional support decreased operative complications 6.38%(3/47)and length of postoperative stay(8.85±2.58)days in geriatric nutritional risk patients compared with those20.93%(9/43),(12.02±5.78)days]without preoperative nutritional support(P<0.05).No significant difference was present between operative complications13.11%(8/61)]and length of postoperative stay(10.56±4.58)days]in the patients with nutritional risk and20.22%(18/89),(11.20±5.95)days]in the patients without nutritional risk(P>0.05),and between10.26%(4/39),(10.03±4.94)days]in nutritional risk patients with preoperative nutritional support and18.19%(4/22),(11.50±3.78)days]in those without preoperative nutritional support(P>0.05).Conclusion GNRI could be used to screen the nutritional risk of the patients with gastrointestinal tumors before operation,and used as a reference for preoperative nutritional support.