简易营养评估法量表在中国老年肺癌手术患者中的应用及与术后并发症相关性分析

目的 通过在中国老年肺癌手术患者人群中应用修订后的简易营养评估法(MNA)量表及简易营养评估精法(MNA-SF)量表,了解中国老年肺癌手术患者的营养状况以及评价营养状况与术后并发症之间的关系.方法 利用修订后的MNA量表及MNA-SF量表对150例2010年6月至2011年6月新人院的老年肺癌准备手术的患者进行术前营养评估,同时收集患者基本资料、患病情况、人体测量指标、生化指标、术后并发症等相关资料.结果 根据MNA修订界值后的评分标准,所调查150例(男98例,女52例)老年肺癌手术患者营养不良的发生率为10.7％(16/150),潜在营养不良发生率为32.0％(48/150),营养正常率为57.3％( 86/150)；MNA得分(23.7±3.8)分,MNA得分与体质指数(BMI)、上臂肌围(MAC)和腓肠肌围(CC)呈正相关(P＜0.01)；MNA-SF得分(11.5±2.4)分,MNA-SF得分与BMI、三头肌皮褶厚度(TSF)、MAC、CC和MNA得分呈正相关(P＜ 0.01或＜0.05)；术后并发症的发生率依次为:呼吸系统37.4％(55/147),心血管系统31.3％(46/147),胸腔0.7％(1/147)；术后并发症不同发病数目之间及发病类型之间的营养状况比较差异无统计学意义(P=0.590、0.601).结论 修订界值后的MNA量表适合于中国老年肺癌手术患者的营养状况评估,评估结果表明老年肺癌手术患者的营养不良发生率较高,其MNA量表评估结果与术后并发症之间相关性有待进一步证实.

Application of mini-nutritional assessment in elderly Chinese operative patients with lung cancer and analysis of its correlation with postoperative complications

Objective To evaluate the nutritional status of elderly Chinese operative patients with lung cancer as well as its correlation with postoperative complications through the application of modified mini-nutritional assessment (MNA) and short-form MNA (MNA-SF).Methods One hundred and fifty elderly Chinese patients with lung cancer underwent operation were enrolled in this study from June 2010 to June 2011.Collected information including preoperative nutritional evaluation in modified MNA and MNA-SF,general information of patients,disease status,anthropometric measurements,biochemical markers,and postoperative complications.Results According to the modified cutoff point of the full MNA in the 150patients (98 males,52 females),10.7％(16/150) patients were malnourished,32.0％(48/150) patients were at risk of malnutrition and 57.3％(86/150) patients were well nourished.MNA was (23.7 ± 3.8) scores.Positive correlations were found between MNA and body mass index (BMI),mid-arm circumference(MAC)and calf circumference (CC) (P ＜ 0.01 ).MNA-SF was ( 11.5 ± 2.4) scores.Positive correlations were found between MNA-SF and BMI,triceps skinfold (TSF),MAC,CC,MNA (P＜0.01 or ＜0.05).The incidence of postoperative complications was as following sequentially: respiratory complication was 37.4％ (55/147),cardiovascular complication was 31.3％(46/147),thoracic cavity complication was 0.7％( 1/147 ).There was no significant difference among groups in different numbers of complications (P=0.590) and among groups in different types of complications (P =0.601 ).Conclusions Modified MNA is suited to elderly Chinese operative patients with lung cancer.Evaluation shows that there is high prevalence of malnutrition among this population,and the correlations between MNA results and postoperative complications should be confirmed in further study.Positive correlations were found between MNA and body mass index (BMI),mid-arm circumference(MAC)and calf circumference (CC) (P ＜ 0.01 ).MNA-SF was ( 11.5 ± 2.4) scores.Positive correlations were found between MNA-SF and BMI,triceps skinfold (TSF),MAC,CC,MNA (P＜0.01 or ＜0.05).The incidence of postoperative complications was as following sequentially: respiratory complication was 37.4％ (55/147),cardiovascular complication was 31.3％(46/147),thoracic cavity complication was 0.7％( 1/147 ).There was no significant difference among groups in different numbers of complications (P=0.590) and among groups in different types of complications (P =0.601 ).Conclusions Modified MNA is suited to elderly Chinese operative patients with lung cancer.Evaluation shows that there is high prevalence of malnutrition among this population,and the correlations between MNA results and postoperative complications should be confirmed in further study.