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目的调查并分析胃癌围手术期患者营养风险、营养支持及临床结局关系。方法应用营养风险筛查2002(NRS 2002)对850例胃癌围手术期患者进行营养风险筛查,并统计患者营养支持情况、住院时间、住院费用和并发症的发生率。结果 850例围手术期胃癌患者中,营养风险发生率为32.4%,其中有营养风险患者中81.5%应用营养支持,而无营养风险患者中有67.5%应用营养支持。有营养风险的胃癌患者并发症发生率、平均住院时间、平均住院费用为分别为26.5%、(21.3±5.7)d、(31 275.7±6 352.2)元,显著高于无营养风险患者12%、(14.5±3.7)d、(23 565.8±4 326.4)元。有营养风险患者中应用营养支持患者并发症发生率、平均住院时间、平均住院费用为分别为18.3%、(18.2±5.7)d、(27 934.5±5 120.7)元,显著低于无营养支持患者62.7%、(27.5±8.3)d、(40 105.7±6 518.3)元。结论胃癌围手术期患者营养风险发生率较高,营养风险与住院患者的临床结局有关,对胃癌患者营养风险筛查并对有营养风险的患者给予营养支持可改善临床结局。
Objective To investigate and analyze the nutritional risk, nutritional support and clinical outcome of perioperative patients with gastric cancer. Methods Nutritional Risk Screening 2002 (NRS 2002) was used to screen 850 nutritional risk patients with perioperative gastric cancer. Nutritional support, hospitalization time, hospitalization expenses and complication rates were calculated. Results The incidence of nutritional risk in 850 patients with perioperative gastric cancer was 32.4%. Among nutritional risk patients, 81.5% were nutritionally supported, and 67.5% of patients without nutritional risk had nutritional support. The incidence of complications, average hospital stay and average hospitalization costs of patients with nutritional risk were 26.5% (21.3 ± 5.7) d and (31 275.7 ± 6 352.2) yuan respectively, significantly higher than those in patients without nutrition risk 12% (14.5 ± 3.7) d, (23 565.8 ± 4 326.4) yuan. The incidence of complication, average length of hospital stay and average hospitalization cost in patients with nutritional risk were 18.3%, (18.2 ± 5.7) d and (27 934.5 ± 5 120.7) yuan, respectively, which were significantly lower than those without nutritional support 62.7%, (27.5 ± 8.3) d, (40 105.7 ± 6 518.3) yuan. Conclusion Perioperative patients with gastric cancer have a higher incidence of nutritional risk and nutritional risk associated with the clinical outcome of hospitalized patients. Nutritional risk screening for patients with gastric cancer and nutritional support for patients at nutritional risk may improve the clinical outcome.