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术前控制营养状况评分对预测肝胆胰大手术后并发症的作用

Preoperative Controlling Nutritional Status Score on Predicting the Postoperative Complications Following Major Hepatopancreatobiliary Surgery.

作者信息

Shrestha Sujan, Dahal Romi, Maharjan Narendra, Pradhan Sumita, Kandel Bishnu, Lakhey Paleswan Joshi, Bhandari Ramesh S

机构信息

Colorectal Surgery, Clinic NEO, Kathmandu, NPL.

Surgical Gastroenterology, Tribhuvan University Teaching Hospital, Institute of Medicine, Kathmandu, NPL.

出版信息

Cureus. 2024 May 30;16(5):e61349. doi: 10.7759/cureus.61349. eCollection 2024 May.

Abstract

Introduction The prognostic significance of the controlling nutritional status (CONUT) score in hepatopancreatobiliary (HPB) surgery has been shown by many studies but the clinical significance of the CONUT score for postoperative short-term outcomes remains controversial. This study aimed to investigate the impact of the CONUT score on early postoperative outcomes in patients following major HPB surgery. Method This was a prospective study of 57 patients who underwent major HPB surgery from November 2019 to January 2021 at the Department of Surgical Gastroenterology, Tribhuvan University Teaching Hospital, Nepal. Result A total of 57 patients, 25 males and 32 females, were operated on. The number of patients assigned to the normal, mild, and moderate malnutrition groups was 13, 41, and 3, respectively. The high CONUT group (CONUT ³ 2) consisted of 44 patients (77%) and the low CONUT group (CONUT <2) consisted of 13 patients (33%). The overall complications (Clavien-Dindo classification ³1) and major complications (Clavien-Dindo classification ³3) were present in 37 patients (64.9%) and 14 patients (24.6%), respectively. Increased operative time and intraoperative blood loss were associated with an increased incidence of major (OR: 1.01, p: 0.018) and overall (OR: 1.006, p: 0.039) postoperative complications, respectively, in univariate analysis. A high CONUT score was not associated with a higher incidence of overall and major postoperative complications. Conclusion In our study, the preoperative CONUT score did not predict the postoperative morbidity following hepatopancreatobiliary surgery.

摘要

引言 多项研究已表明控制营养状况(CONUT)评分在肝胰胆(HPB)手术中的预后意义,但CONUT评分对术后短期结局的临床意义仍存在争议。本研究旨在探讨CONUT评分对接受大型HPB手术患者术后早期结局的影响。方法 这是一项对2019年11月至2021年1月在尼泊尔特里布万大学教学医院外科胃肠病科接受大型HPB手术的57例患者进行的前瞻性研究。结果 总共57例患者接受了手术,其中男性25例,女性32例。营养正常、轻度营养不良和中度营养不良组的患者人数分别为13例、41例和3例。高CONUT组(CONUT≥2)由44例患者(77%)组成,低CONUT组(CONUT<2)由13例患者(33%)组成。总体并发症(Clavien-Dindo分类≥1)和严重并发症(Clavien-Dindo分类≥3)分别出现在37例患者(64.9%)和14例患者(24.6%)中。在单因素分析中,手术时间延长和术中失血分别与术后严重(OR:1.01,p:0.018)和总体(OR:1.006,p:0.039)并发症发生率增加相关。高CONUT评分与术后总体和严重并发症的较高发生率无关。结论 在我们的研究中,术前CONUT评分不能预测肝胰胆手术后的术后发病率。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fd71/11214119/5bba8ba52e83/cureus-0016-00000061349-i01.jpg

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