营养风险筛查对结直肠癌手术死亡率和并发症发生率的预测价值

目的 探讨营养风险筛查对结直肠癌手术死亡率和并发症发生率的预测价值.方法 前瞻性将2006年1月至2009年12月间福建省莆田学院附属医院行择期开腹手术的289例结直肠癌患者.分别按照Reilly营养风险评分（Reilly NRS）和欧洲临床营养与代谢协会的营养风险评分（NRS-2002）进行营养风险筛查.结果 289例患者围手术期死亡率为3.5%（10/289）,术后并发症发生率为29.4%（82/279）.按Reilly NRS评分,营养风险组（≥4分,89例）和无营养风险组（＜4分,200例）的围手术期死亡率分别为5.6%（5/89）和2.5%（5/200）（P＞0.05）;术后并发症发生率分别为36.1%（31/83）和26.5%（51/196）（P＞0.05）.按NRS-2002评分,营养风险组（≥3分,105例）和无营养风险组（＜3分,184例）的围手术期死亡率分别为5.7%（6/105）和2.2%（4/184）（P＞0.05）;术后并发症发生率分别为38.4%（38/99）和24.4%（44/180）（P＜0.05）.经多因素逻辑回归分析证实,NRS-2002评分是结直肠癌手术后并发症的独立危险因素（P=0.007,OR=3.14,95%CI：1.63～6.29）.结论 NRS-2002评分作为一种术前营养风险筛查方法,可有效预测结直肠癌手术后并发症的发生率.

Impact of nutritional status on postoperative outcomes for patients with colorectal cancer

Objective To evaluate the impact of nutritional status on postoperative outcomes for patients with colorectal cancer. Methods Data of 289 colorectal cancer patients from the Affiliated Hospital of Putian Medical College between January 2006 and December 2009 were collected prospectively. Nutritional status was evaluated according to Reilly Nutrition Risk Score(Reilly NRS)and Nutrition Risk Screening 2002(NRS-2002). Results The postoperative mortality was 3.5%(10/289)and the complication rate was 29.4%(82/297). Patients were stratified into those at nutrition risk (n=89) and those not at risk (n=200) according to Reilly NRS and the two groups were similar in mortality rate (5.6% vs. 2.5%, P＞0.05) and complication rate (36.1% vs. 26.5%, P＞0.05). When stratified using NRS-2002, patients at nutritional risk(n=105) had a similar mortality rate (5.7% vs.2.2%, P＞0.05) but a higher complication rate (38.4% vs. 24.4%, P＜0.05). NRS-2002 remained as an significant predictor of postoperative complications (P=0.007, OR=3.14, 95% CI: 1.63-6.29) on multivariable logistic regression analysis. Conclusion As a nutritional evaluation tool, NRS-2002 may predict postoperative comphcation for colorectal cancer.