[1]邹红波,余鼎业,严夏霖,等.基于CT的肌肉质量对伴有营养风险的老年胃癌病人临床预后的影响[J].肠外与肠内营养杂志,2021,(03):129-134.[doi:10.16151/j.1007-810x.2021.03.001]
　ZOU Hong-bo,YU Ding-ye,YAN Xia-lin,et al.The effect of low muscle mass as measured on CT scans on clinical outcome in elderly gastric cancer patients with nutritional risks[J].PARENTERAL & ENTERAL NUTRITION,2021,(03):129-134.[doi:10.16151/j.1007-810x.2021.03.001]
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基于CT的肌肉质量对伴有营养风险的老年胃癌病人临床预后的影响
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《肠外与肠内营养》杂志[ISSN:1007-810X/CN:32-1477/R]

卷:
期数:
2021年03期
页码:
129-134
栏目:
论著
出版日期:
2021-05-10

文章信息/Info

Title:
The effect of low muscle mass as measured on CT scans on clinical outcome in elderly gastric cancer patients with nutritional risks
作者:
邹红波 1; 余鼎业2; 严夏霖3; 董文玺 1; 陈文豪 1; 余 震1; 3
1.温州医科大学附属第一医院胃肠外科，浙江温州325000；2.上海交通大学附属瑞金医院胃肠外 科，上海 200025；3.同济大学附属第十人民医院胃肠外科，上海 200072
Author(s):
ZOU Hong-bo1;  YU Ding-ye2;  YAN Xia-lin3;  DONG Wen-xi1;  CHEN Wen-hao1;  YU Zhen1; 3
1.Department of Gastrointestinal Surgery, The First Affiliated Hospital, Wenzhou Medical;University, Wenzhou 325000, Zhejiang, China；2.Department of Gastrointestinal Surgery, Ruijin Hospital Affiliated to Shanghai Jiao Tong University School, Shanghai 200025, China；3.Department of Gastrointestinal Surgery, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai 200072, China
关键词:
胃癌 ; 营养风险 ; CT ; 骨骼肌指数 ; 术后并发症
Keywords:
Gastric cancer;  Nutritional risk;  CT;  Skeletal muscle index;  Postoperative outcomes
分类号:
R459.3，R656.6+1
DOI:
10.16151/j.1007-810x.2021.03.001
文献标志码:
A
摘要:
目的：探讨基于CT的第三腰椎骨骼肌指数对伴有营养风险的老年胃癌病人术后并发症的预测价值。 方法：收集2014年8月至2019年6月期间温州医科大学附属第一医院胃肠外科限期行胃癌根治术病人的一般资料，包括性别、年龄、身高、体质量等。术前利用NRS 2002筛查病人营养风险，CT评估第三腰椎骨骼肌指数；术后记录病人 30 d 内的术后并发症。 结果：共有 278 例病人参加了这项研究，其中低骨骼肌指数病人 154 例（55.4%）。相较正常骨骼肌指数组，低骨骼肌指数组的胃癌病人平均年龄更大[(74.71 ± 5.92)岁 vs (72.14 ± 4.79) 岁,P < 0.001]，BMI[(19.94 ± 2.38) kg/m2 vs (22.82 ± 3.25)kg/m2，P < 0.001]和血清白蛋白含量[(34.90 ± 4.65) g/L vs (36.73 ± 3.80) g/L, P < 0.001]更低。除此之外，该组病人术后住院时间显著延长[(18.84 ± 11.72) d vs (16.33 ± 11.74)d，P = 0.008]、住院费用显著增加。多因素分析显示，低骨骼肌指数（OR = 2.512，95%CI：1.440 ~ 4.380，P = 0.001）是术后并发症的独立预测因素。 结论：基于CT评估的肌肉质量减少会显著增加术前伴有营养风险的老年胃癌病人术后并发症发生率。
Abstract:
Objective: To investigate the predictive value of the third lumbar skeletal muscle index as measured on computed tomography (CT) for postoperative complications in elderly gastric cancer patients with nutritional risks. Methods: The patients who underwent radical gastrectomy between August 2014 and June 2019 in the Department of Gastrointestinal Surgery, the First Affiliated Hospital of Wenzhou Medical University, were enrolled in this study. Nutrition Risk Screening (NRS 2002) was conducted for evaluating the nutritional status of the enrolled patientsand the third lumbar skeletal muscle mass was estimated preoperatively by CT scans. Postoperative complications within 30 days were recorded. Result: A total of 278 patients were recruited in the study, 154 of which (55.4%) had low skeletal muscle index based on CT scans. Compared with the normal skeletal muscle index group (72.14 ± 4.79) yrs, the cases with low skeletal muscle index had older ages [(74.71 ± 5.92) yrs, P < 0.001], lower body mass index (BMI) [(19.94 ± 2.38) kg/m2 vs (22.82 ± 3.25) kg/m2, P < 0.001), and lower albumin [(34.9 ± 4.65) g/L vs (36.73 ± 3.80) g/L P < 0.001].In addition, the duration of postoperative hospital stays was significantly prolonged [(18.84 ± 11.72) d vs (16.33±11.74) d, P = 0.008], and the costs were also increased. In multivariate analysis, low skeletal muscle index (OR = 2.512, 95% CI 1.440 ~ 4.380, P = 0.001) was considered as an independent predictor for postoperative complications. Conclusion: The muscle mass loss based on CT scans might result in a significant increase in the prevalence of postoperative complications in elderly gastric cancer patients with preoperative nutritional risk.

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备注/Memo

备注/Memo:
基金项目 ：国家自然科学基金（81770884，81800795） 作者简介 ：邹红波，医学硕士研究生，主要从事临床营养研究。E-mail：380506604@qq.com 通讯作者 ：余 震，E-mail：yuzhen0577@163.com
更新日期/Last Update: 1900-01-01