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术前营养风险评估对预测膀胱癌根治性膀胱切除术加尿流改道术后并发症的作用

Preoperative Nutritional Risk Assessment for Predicting Complications after Radical Cystectomy plus Urinary Diversion for Bladder Cancer.

作者信息

Wei Xing, Wang Jia, Liu Haitao, Fan Weizhe, Guo Gang

机构信息

Department of Urology, The 3rd Medical Center of Chinese People's Liberation Army General Hospital, Beijing 100039, China.

Department of Urology Surgery, The First Affiliated Hospital of Air Force Military Medical University, Xi'an, Shaanxi 710032, China.

出版信息

Emerg Med Int. 2022 Aug 16;2022:2901189. doi: 10.1155/2022/2901189. eCollection 2022.

Abstract

OBJECTIVE

To investigate the predictive value of preoperative nutritional risk assessment on the occurrence of complications after radical cystectomy plus urinary diversion for bladder cancer.

METHODS

Retrospective analysis of 178 patients with bladder cancer between July 2010 and March 2022 who underwent elective radical cystectomy plus urinary diversion was conducted. The occurrence of complications within 90 days after surgery was counted for all patients, and the postoperative complication rates of patients with and without nutritional risk were compared and analyzed. Also, logistic regression analysis was used to assess the relative risk coefficients of NRS-2002 and the occurrence of postoperative complications.

RESULTS

Comparison of clinicopathological characteristics and surgical conditions between the two groups showed that the proportion of combined diabetes mellitus, operative time, and postoperative hospital stay were higher in the nutritional risk group (NRS ≥3 score) than in the no nutritional risk group (NRS <3 score), while the preoperative blood albumin (ALB) level was lower than that in the no nutritional risk group (NRS <3 score). The results of multifactorial risk regression analysis showed that low preoperative ALB level and high NRS score were independent risk factors for postoperative complications in bladder cancer ( < 0.05).

CONCLUSION

The NRS-2002 nutritional risk score has good predictive value for the incidence of postoperative complications in patients with bladder cancer and provides a scientific basis for perioperative nutritional support.

摘要

目的

探讨术前营养风险评估对膀胱癌根治性膀胱切除术加尿流改道术后并发症发生情况的预测价值。

方法

回顾性分析2010年7月至2022年3月期间178例行择期根治性膀胱切除术加尿流改道的膀胱癌患者。统计所有患者术后90天内并发症的发生情况,比较并分析有营养风险和无营养风险患者的术后并发症发生率。同时,采用logistic回归分析评估NRS-2002与术后并发症发生的相对风险系数。

结果

两组患者临床病理特征及手术情况比较显示,营养风险组(NRS≥3分)合并糖尿病比例、手术时间及术后住院时间均高于无营养风险组(NRS<3分),而术前血白蛋白(ALB)水平低于无营养风险组(NRS<3分)。多因素风险回归分析结果显示,术前ALB水平低和NRS评分高是膀胱癌术后并发症的独立危险因素(<0.05)。

结论

NRS-2002营养风险评分对膀胱癌患者术后并发症发生率具有良好的预测价值,为围手术期营养支持提供了科学依据。

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