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胃肠道肿瘤患者术后恢复与 NRS 2002 筛查的营养风险及营养支持状况的关系。

Relationship between Postoperative Recovery and Nutrition Risk Screened by NRS 2002 and Nutrition Support Status in Patients with Gastrointestinal Cancer.

机构信息

Department of nutrition and food hygiene, School of Public Health, Anhui Medical University, Hefei, Anhui, China.

Department of Nutrition, Zhenjiang First People's Hospital, Zhenjiang, China.

出版信息

Nutr Cancer. 2020;72(1):33-40. doi: 10.1080/01635581.2019.1612927. Epub 2019 May 11.

Abstract

Investigating incidence of nutritional risk and nutrition support in gastrointestinal cancer patients to provide reference for improving the clinical nutritional application level. We evaluated the nutritional risk of gastrointestinal cancer patients who were newly admitted from September 2015 to February 2016 by Nutritional Risk Screening 2002 (NRS 2002). Totally, 201 cases completed assessment by NRS 2002, and 69 cases (34.3%) were at nutritional risk. The incidence of nutritional risk was higher in patients with ≥65 ( < 0.05), with tumor size ≥ 5 cm ( < 0.05) or well-differentiated ( < 0.001). Incidence of nutritional risk in patients with BMI < 18.5 was higher than patients with BMI 18.5-25 and ≥25 ( < 0.05). Patients with nutrition risk had greater rate of anemia than with no risk. In nutritional risk group, 54 cases underwent enteral nutrition support, and their hospitalization stay was shorter, and the rates of complications were smaller ( < 0.05). Further multivariate logistic regression analysis showed NRS 2002 score, middle differentiation degree and III/I were the risk factors for postoperative complication. Preoperative NRS 2002 score was proved to be a predictive index for postoperative complication rate, and this indicates that patients with a high preoperative NRS 2002 score are at higher risk of developing postoperative complications and longer recovery period.

摘要

调查胃肠道癌症患者营养风险和营养支持的发生率,为提高临床营养应用水平提供参考。我们采用营养风险筛查 2002 (NRS 2002)对 2015 年 9 月至 2016 年 2 月新入院的胃肠道癌症患者进行营养风险评估。共 201 例患者完成 NRS 2002 评估,其中 69 例(34.3%)存在营养风险。≥65 岁( < 0.05)、肿瘤直径≥5cm( < 0.05)或分化程度差( < 0.001)的患者营养风险发生率较高。BMI<18.5 的患者营养风险发生率高于 BMI 为 18.5-25 和≥25 的患者( < 0.05)。有营养风险的患者贫血发生率高于无营养风险的患者。在营养风险组中,54 例患者接受了肠内营养支持,其住院时间更短,并发症发生率更小( < 0.05)。进一步的多变量 logistic 回归分析显示,NRS 2002 评分、中分化程度和 III/III 期是术后并发症的危险因素。术前 NRS 2002 评分是术后并发症发生率的预测指标,表明术前 NRS 2002 评分较高的患者术后并发症风险较高,恢复时间较长。

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