Shimakawa Takeshi, Asaka Shinich, Sagawa Masano, Shimazaki Asako, Yamaguchi Kentaro, Usui Takebumi, Yokomizo Hajime, Shiozawa Shunichi, Yoshimatsu Kazuhiko, Katsube Takao, Naritaka Yoshihiko
Dept. of Surgery, Tokyo Women's Medical University, Medical Center East.
Gan To Kagaku Ryoho. 2014 Oct;41(10):1301-3.
The incidence of postoperative complications and mortality are usually higher in patients with preoperative malnutrition. Malnutrition often preexists, particularly in patients undergoing surgery for esophageal cancer, which is substantially invasive. It is therefore important to understand the nutritional condition of patients and actively control perioperative nutrition.Our hospital has been providing nutritional status screening for patients before resection of esophageal cancer, and we report the current status and evaluation results in this article.This screening included 158 patients requiring radical resection of esophageal cancer.Age, comorbidity with diabetes, body mass index(BMI), serum albumin(Alb), Onodera's prognostic nutritional index(PNI), and Glasgow prognostic score(GPS)were used as nutritional indicators to stratify patients for analysis.Evaluation parameters included the incidence of postoperative complications(any complication, pulmonary complications, psychiatric disorder, and anastomotic leakage)and rates of long-term postoperative hospitalization.The analysis indicated that age, BMI, serum Alb, PNI, and GPS are useful for predicting the onset of postoperative complications and prolonged postoperative hospitalization.For such patients, more active nutritional control should be provided.
术前存在营养不良的患者术后并发症发生率和死亡率通常更高。营养不良往往早已存在,尤其是在接受食管癌手术的患者中,这类手术具有较大的侵袭性。因此,了解患者的营养状况并积极控制围手术期营养非常重要。我院一直在对食管癌切除术前的患者进行营养状况筛查,本文报告当前的状况及评估结果。此次筛查纳入了158例需要行食管癌根治性切除术的患者。将年龄、糖尿病合并症、体重指数(BMI)、血清白蛋白(Alb)、小野寺预后营养指数(PNI)和格拉斯哥预后评分(GPS)作为营养指标,对患者进行分层分析。评估参数包括术后并发症发生率(任何并发症、肺部并发症、精神障碍和吻合口漏)以及术后长期住院率。分析表明,年龄、BMI、血清Alb、PNI和GPS有助于预测术后并发症的发生及术后住院时间延长。对于这类患者,应提供更积极的营养控制。