营养风险与腹膜后肿瘤患者住院时间的相关性研究

doi:10.16689/j.cnki.cn11-9349/r.2020.02.008

摘要
图/表
参考文献
相关文章 (15)

全文: PDF (415 KB) HTML (1 KB)
输出: BibTeX | EndNote (RIS)

摘要目的探讨营养风险与腹膜后肿瘤患者住院时间的相关性。方法采用回顾性研究，选取2012年1月至2018年12月四川大学华西医院血管外科新入院腹膜后肿瘤患者60例，采用营养风险筛查表评估患者营养风险，收集患者体质指数、围术期血红蛋白和白蛋白水平、住院天数、术后恶心呕吐发生情况、术后排气、排便时间和首次进食时间。采用单因素分析比较不同患者住院时间，采用多重线性逐步回归分析患者住院时间的影响因素。结果纳入的60例腹膜后肿瘤患者中，40例患者（66.7%）术前存在营养风险，52例患者（86.7%）术后存在营养风险；单因素分析显示，患者术前、术后营养风险（术前P<0.001，术后P=0.043）、术前白蛋白（P=0.019）、术后血红蛋白（P=0.019）、术后白蛋白（P=0.025）水平以及术后恶心呕吐（P=0.001）均会影响患者的住院时间；患者住院时间与围术期营养风险筛查工具评分、术后首次进食时间、术后排气时间和排便时间具有相关性，且相关性强（r=0.759~0.770； P<0.01）；多因素分析显示术前营养风险是腹膜后肿瘤患者住院时间的重要预测因素（β=0.399）。结论术前营养风险是腹膜后肿瘤患者住院时间的预测因子。

	服务

	把本文推荐给朋友
	加入我的书架
	加入引用管理器
	E-mail Alert
	RSS
	作者相关文章
	黄靖
	刘莉
	刘莉慧
	张林
	张洁
	何英
	刘晓艳

关键词 ：腹膜后肿瘤, 营养风险, 住院时间

Abstract：Objective This study aimed to explore the relationship between nutrition risks and length of hospital stay in patients with retroperitoneal tumor， and to provide the strategy of clinical nutritional support therapy. Methods 60 patients with retroperitoneal tumor were recruited from a tertiary academic hospital in Chengdu. Nutritional risk was assessed by the European nutritional risk screening scale （NRS 2002） in a retrospective study．In addition， some data on admission and discharge were collected， such as body mass index （BMI）， blood albumin， blood hemoglobin， length of hospital stay （LOS）， postoperative nausea and vomiting （PONV）， exhaust time， defecation time， and time for dieting after surgery. One-way ANOVA were used to compare the length of hospital stay of patients between two groups and three groups， respectively. Multiple linear stepwise regression analysis was used to analyze the influence factors of length of hospital stay of patients. Results Among all patients with retroperitoneal tumor （n=60）， the prevalence of nutritional risk before and after operation were 66.7% and 86.7%. Univariate analysis of the factors influencing the LOS of patients showed that patients with nutritional risks were more likely to stay longer in hospital compared to those without （P<0.001， P=0.043）. Others factors associated with prolonged LOS were low blood albumin level （P=0.019， P=0.025） during perioperative period， low blood hemoglobin level （P=0.019） after surgery， and PONV （P=0.001）. A positive correlation between exhaust time， defecation time， time for dieting after surgery and LOS was observed， and the strength of the association was strong （r=0.759-0.770； P<0.001）.Multiple linear stepwise regression analysis indicated that the NRS 2002 of patients with retroperitoneal tumor was significantly predict LOS among the participants （β=0.399）. Conclusion Nutritional risk assessed by NRS 2002 on admission predicts LOS for patients with retroperitoneal tumor. A large scaled prospective study is needed to confirm whether supplementing nutritional deficits reduces LOS.

Key words： Retroperitoneal tumor Nutrition risk Length of hospital stay

基金资助:华西医院博士后基金（2018JXBH045）

通讯作者: 刘晓艳，电子邮箱：lxy711010@163.com

引用本文:

黄靖，刘莉，刘莉慧，张林，张洁，何英，刘晓艳. 营养风险与腹膜后肿瘤患者住院时间的相关性研究[J]. 肿瘤代谢与营养电子杂志, 2020, 7(2): 178-182.
Huang Jing， Liu Li， Liu Lihui， Zhang Lin， Zhang Jie， He Ying， Liu Xiaoyan. The nutritional risk and the relation to length of hospital stay among patients with retroperitoneal tumor. Electron J Metab Nutr Cancer, 2020, 7(2): 178-182.

1.罗成华，苗成利.腹膜后肿瘤的手术治疗策略与新趋势［J］.中国普外基础与临床杂志， 2016，（3）: 257-259.
2.MOZER M， PETERSON S， SOWA D. Utilizing the patient-generated subjective global assessment as a tool to identify malnutrition in radiation oncology patients［J］. J Acad Nutr Diet， 2017， 117（9）: A38-A38.
3.JENSON B T， DALBAGNI G， BORRE M，et al. Preoperative nutritional status and the impact on radical cystectomy recovery: an international comparative study［J］. Urol Nurs， 2016， 36（3）: 133-140， 152.
4.DIAS M C G， VAKENTE G， ROCHA M H M D， et al.Nutrition support team performance and outcome of hospitalized patients in a tertiary-level hospital in So Paulo［J］. Clin Nutr， 2018， 37: S164-S165.
5.ZHONG J X， KANG K， SHU X L. Effect of nutritional support on clinical outcomes in perioperative malnourished patients: a meta-analysis［J］. Asia Pac J Clin Nutr， 2015， 24（3）: 367-378.
6.SWAN W I， VIVANTi A， HAKEL-SMITH N A， et al. Nutrition care process and model update: toward realizing people-centered care and outcomes management［J］. Journal of the academy of nutrition and dietetics， 2017， 117（12）: 2003-2014.
7.KONDRUP J， RASMUSSEN H H， HAMBERG O， et al. Nutritional risk screening （NRS 2002 ）: a new method based on an analysis of controlled clinical trials［J］.Clin Nutr， 2003， 22（3）: 321-336.
8.OTTERY F D. Rethinking nutritional support of the cancer patient: the new field of nutritional oncology［J］. Semin Oncol， 1994， 21（6）: 770-778.
9.石汉平，李薇，王昆华.PG-SGA-肿瘤病人营养状况评估操作手册［M］.北京: 人民卫生出版社， 2013.
10.YE J F， CHEN Y， CAI J F， et al. Incidence and risk factors for anemia among newly-diagnosed intestinal Behcet’s disease patients［J］. J Natl Med Assoc， 2019， 111（4）: 407-412.
11.KONDRUP J， RASMUSSEN H H， HAMBERG O， et al. Nutritional risk screening （NRS 2002）: a new method based on an analysis of controlled clinical trials［J］. Clin Nutr， 2003， 22（3） : 321-336.
12.杨剑，张明，蒋朱明，等. 营养筛查与营养评估: 理念、临床实用及误区［J］.中国临床营养杂志， 2017， 25（1）: 59-64.
13.LVARO SANZ E， GARRIDO SILES M， REY FERNNDEZ L， et al. Nutritional risk and malnutrition rates at diagnosis of cancer in patients treated in outpatient settings: early intervention protocol［J］. Nutrition， 2019， 57: 148-153.
14.朱明炜，韦军民，陈伟，等.恶性肿瘤患者住院期间营养风险变化的动态调查［J］.中华医学杂志， 2018， 98（14）: 1093-1098.
15.ZITVNGEL L，PIETROCALA F，KROEMER G.Nutrition， inflammation and cancer［J］.Nat Immunol， 2017， 18（8）: 843-850．
16.黎介寿.营养支持治疗与加速康复外科［J］.肠外与肠内营养， 2015， 22（2）: 65-67.
17.BARCLAY K L， ZHU Y Y， TACEY M A. Nausea， vomiting and return of bowel function after colorectal surgery［J］. ANZ J Surg， 2015， 85（11）: 823-828.
18.MC LOUGHLIN S， TERRASA S A， LJUNGQVIST O， et al. Nausea and vomiting in a colorectal ERAS program: Impact on nutritional recovery and the length of hospital stay［J］. Clin Nutr ESPEN， 2019， 34: 73-80.
19.CEREDA E， KLERSY C， PEDROLLI C， et al.The geriatric nutritional risk index predicts hospital length of stay and in-hospital weight loss in elderly patients［J］. Clin Nutr， 2015， 34（1）: 74-78.
20.王贺.恶性肿瘤住院患者营养状况与临床结局相关性的前瞻性研究［D］.陆军军医大学， 2018.
21.SUN Z， KONG X J， JING X， et al. Nutritional risk screening 2002 as a predictor of postoperative outcomes in patients undergoing abdominal surgery: a systematic review and meta-analysis of prospective cohort studies［J］. PLoS one ［electronic resource］， 2015， 10（7）: e0132857.
22.KWAG S J， KIM J G， KANG W K， et al. The nutritional risk is a independent factor for postoperative morbidity in surgery for colorectal cancer［J］. Ann Surg Treat Res， 2014， 86（4）: 206-211.
23.KRUIZENGA H， VAN KEEKEN S， WEIJS P， et al. Undernutrition screening survey in 564，063 patients: patients with a positive undernutrition screening score stay in hospital 1.4 d longer［J］. Am J Clin Nutr， 2016， 103（4）: 1026-1032.
24.JEFF EHRESMAN A， KARIM A， ANDREW S， et al. Preoperative nutrition consults associated with decreased postoperative complication rate and decreased length of hospital stay after spine metastasis surgery［J］.World Neurosurg， 2020， 133: e173-e179.
25.SANTOS C A， FONSECA A， ALMEIDA A， et al. How the nutritional risk in hospitalized patients determines the customization diet and length of stay: a retrospective study［J］. Clin Nutr， 2019， 38: s152-s152.
26.AFANEH C， GERSZBERG D， SLATTERY E， et al. Pancreatic cancer surgery and nutrition management: a review of the current literature［J］. Hepatobiliary Surg Nutr， 2015， 4（1）: 59-71.
27.WILLIAMS J D， WISCHMEYER P E. Assessment of perioperative nutrition practices and attitudes-a national survey of colorectal and GI surgical oncology programs［J］.Am J Surg， 2017， 213（6）: 1010-1018.
28.石汉平.营养疗法应该成为肿瘤患者的基本治疗［J］.中华结盲肠疾病电子杂志， 2013， 2（3）: 2-4.
29.STATTON R J， HEBUTENE X， ELIA M. A systematic review and meta-analysis of the impact of oral nutritional supplements on hospital readmissions［J］. Ageing Res Rev， 2013， 12（4）: 884-897.