胃肠道肿瘤患者营养风险筛查特点及其对术后并发症的影响

目的评估胃癌和大肠癌患者的营养状态特点,探讨营养风险与患者术后并发症的关系。方法以286例符合条件的胃肠道恶性肿瘤患者为研究对象,由受过专门培训的护理人员通过详细的问诊和身体测量于入院24 h内应用营养风险筛查（NRS 2002）工具完成营养风险筛查。出院前记录术后相关并发症,并根据并发症Clavien-Dindo评分系统评估并发症严重程度。两独立样本之间的比较采用t检验或χ2检验。结果共有132例患者总评分≥3分,存在营养风险,占46.2%。163例胃癌患者中,存在营养风险患者84例,占51.5%;123例大肠癌患者中,存在营养风险患者48例,占39.0%,两者之间的差异具有统计学意义。胃癌患者的营养受损评分（1.58±0.42 vs.1.25±0.39）显著高于大肠癌。营养风险组的并发症例次发生率（46.2%vs 34.4%）和并发症分级（2.24±0.85 vs.1.79±0.57）均显著高于非营养风险组。结论胃肠道肿瘤患者容易发生营养风险,尤其是胃癌患者。处于营养风险状态的患者,术后并发症多且严重,术前应用NRS 2002评估胃肠道肿瘤患者的营养风险是必要和重要的。

Nutrition risk screening in patients with gastrointestinal cancer and its impact on postoperative complications

Abstract：Objective To assess the characteristics of nutritional status of patients with gastric cancer or eolorectal canc- er, and explore the relationship between nutrition risk and the postoperative complications. Methods Total 286 eligible patients with gastrointestinal cancer were enrolled in this study. Nutritional Risk Screening（ NRS 2002） was used to assess nutritional risk status within 24 h of admission with detailed interrogation and body measurements by specially trained nur- ses. Postoperative complieations were recorded and assessed based on Clavien-Dindo scoring system before discharge. Student＇ s t-test olx2-test was applied for the two independent samples. Results A total of 132 patients were with nutri- tional risk （/〉 3 ）, accounting for 46.2 %. In 163 cases of gastric cancer, 84 cases were with nutritional risk, accounting for 51.5% ;In 123 cases of eoloreetal cancer patients,48 cases were with nutritional risk, accounting for 39.0%. There was significant difference between the two groups. The incidenee of nutritional damage scores in gastric cancer patients was significantly higher than that in colorectal cancer patients （ 1.58 ＋ 0.42 vs. 1.25 -＋ 0.39）. The incidence of complications in cases and complications grading in nutritional risk group were significantly higher than that in non-nutritional risk groups（46.2% vs. 34.4% ;2.24 -＋ 0.85 vs. 1.79 ＋ 0.57）. Conclusion The patients with gastrointestinal cancer prone to be in nutritional risk, especially in patients with gastric cancer. The patients at nutritional risk status have more and more serious postoperative eomplications. It is necessary and important to assess nutritional risk of gastrointestinal eaneer patients with NRS 2002 preoperatively.