营养风险筛查对胃癌手术并发症发生率的预测价值

摘要

Objective:To evaluate the effect of nutritional status on postoperative outcomes for patients with gastric cancer. Methods:Data of 353 gastric cancer patients at Xinjiang Medical University Affiliated Tumor Hospital between January 2013 and October 2014 were collected prospectively. Preoperative nutritional status was evaluated using Nutrition Risk Screening 2002 (NRS 2002). Postoperative complication rates were compared among different preoperative nutritional status. Results:On the basis of NRS 2002, the morbidities of patients with and without malnutrition risk were 47.0%(77/164) and 31.2%(59/189), respectively (P=0.002). Among the patients with an NRS score of at least 3, the complication rate was significantly lower in the group with preoperative nutrition than in the group of patients without preoperative nutrition support (P=0.013). NRS 2002 was a significant predictor of postoperative complications (P=0.039, OR=1.634, 95%CI:1.025-2.606) on the basis of multivariable logistic regression analysis. Conclusion:As a nutritional evaluation tool, NRS 2002 may predict postoperative complications for gastric cancer patients.%目的：探讨营养风险筛查对胃癌手术后并发症发生率的预测价值。方法：对2013年1月至2014年10月新疆医科大学附属肿瘤医院胃肠外科择期行胃癌根治术的353例胃癌患者，采用欧洲营养风险筛查2002（NRS 2002）评分进行术前营养评估，比较存在营养风险的患者和无营养风险的患者术后并发症发生率。结果：按照NRS 2002评分，术前存在营养风险和无营养风险者术后并发症发生率分别为47.0%（77/164）和31.2%（59/189），差异有统计学意义（P=0.002）。NRS 2002评分≥3分的患者，术前有营养支持比无营养支持并发症发生率低，差异有统计学意义（P=0.013）。经Logistic多因素风险回归分析证实，NRS 2002评分是胃癌手术后并发症的独立危险因素（P=0.039，0R=1.634，95%CI：1.025～2.606）。结论：NRS 2002评分作为一种术前营养风险筛查方法，可有效预测胃癌手术后并发症的发生率。