摘要
目的:探讨营养风险指数(NRI)预测腹腔镜胃癌根治术后早期并发症的价值。方法:回顾分析2019年1月至2024年12月行腹腔镜胃癌根治术的150例患者的临床资料,总结术后发生早期并发症的危险因素。术后34例(22.67%)发生早期并发症(并发症组),余116例患者作为对照组,采用单因素与多因素Logistic回归分析胃癌根治术后发生早期并发症的危险因素,采用受试者操作特征曲线下面积评估NRI预测胃癌根治术后早期并发症的价值,确认其最佳临界值,据此将患者分为高营养风险组与低营养风险组,并比较两组临床资料。结果:单因素分析显示,并发症组与对照组患者年龄、白蛋白、NRI、淋巴细胞总数、淋巴结清扫数量、病理分期差异有统计学意义(P<0.05)。多因素Logistic回归分析显示,NRI是术后发生早期并发症的保护因素(OR=0.883,95%CI=0.818~0.953,P<0.001);NRI评估胃癌根治手术后并发症的曲线下面积为0.776,最佳临界值为93.119;对全胃切除(AUC=0.869,临界值94.670)与部分胃切除(AUC=0.721,临界值90.756)患者均具有良好的预测价值。高营养风险组术后早期并发症总发生率高于低营养风险组(P<0.001)。结论:NRI<93.119可作为术前营养干预的客观指标。对于术前NRI<93.119的患者,术前应及时予以营养支持。
Objective:To explore the value of the nutritional risk index(NRI)in predicting early complications after laparoscopic radical gastrectomy.Methods:The clinical data of 150 patients who underwent laparoscopic radical gastrectomy between Jan.2019 and Dec.2024 were retrospectively analyzed to summarize the risk factors for early postoperative complications.Early postoperative complications occurred in 34 cases(22.67%),which were classified as the complication group,and the remaining 116 patients served as the control group.Univariate and multivariate logistic regression analyses were used to identify the risk factors for early postoperative complications after radical gastrectomy for gastric cancer.The area under the receiver operating characteristic curve was used to evaluate the value of NRI in predicting early postoperative complications after radical gastrectomy for gastric cancer,and the optimal cut-off value was confirmed.Accordingly,patients were divided into the high nutritional risk group and the low nutritional risk group,and the clinical data of the two groups were compared.Results:Univariate analysis revealed statistically significant differences in age,albumin,NRI,total lymphocyte count,number of lymph nodes dissected,and pathological stage between the complication group and the control group(P<0.05).Multivariate logistic regression analysis showed that NRI was a protective factor for early postoperative complications(OR=0.883,95%CI=0.818~0.953,P<0.001).The area under curve of NRI in evaluating postoperative complications after radical gastrectomy for gastric cancer was 0.776,with an optimal cut-off value of 93.119.It exhibited favorable predictive value for both total gastrectomy patients(AUC=0.869,cut-off value=94.670)and partial gastrectomy patients(AUC=0.721,cut-off value=90.756).The total incidence of early postoperative complications in the high nutritional risk group was higher than that in the low nutritional risk group(P<0.001).Conclusions:NRI<93.119 can serve as an objective indicator for preoperative nutritional intervention.Patients with preoperative NRI<93.119 should be given preoperative nutritional support in time.
作者
赵强
汪勇
吴文涌
ZHAO Qiang;WANG Yong;WU Wenyong(Graduate School of Bengbu Medical University,Bengbu 233000,China;Department of Gastrointestinal Surgery,the Second People′s Hospital of Anhui Province)
出处
《腹腔镜外科杂志》
2026年第1期23-29,共7页
Journal of Laparoscopic Surgery
基金
安徽省高校自然科学研究项目(2023AH010084)
青年科学基金项目(2023xkj118)。
关键词
胃肿瘤
胃癌根治术
腹腔镜检查
营养风险指数
手术后并发症
Stomach neoplasms
Radical gastrectomy for gastric cancer
Laparoscopy
Nutritional risk index
Postoperative complications
