摘要
目的:探讨胃癌(GC)病人术前贫血情况、危险因素及术后并发症,为围手术期的处理提供依据.方法:对某三级医院500 例GC病人围手术期的临床资料进行分析,探讨GC病人术前贫血情况、危险因素及术后并发症.结果:500 例病人中,贫血病人212 例(42.4%),非贫血病人288 例(57.6%);贫血组与非贫血组在年龄、体质量指数(BMI)、红细胞计数(RBC)、血红蛋白(Hb)、红细胞分布宽度(RDW-CV)、血清总蛋白(TP)、白蛋白(Alb)、三酰甘油(TG)及总胆固醇(TCH)指标上差异均具有统计学意义(P<0.01);单因素分析显示,年龄≥65 岁、合并慢性阻塞性肺疾病、腹部手术史、BMI<18.5 kg/m2、营养风险筛查(NRS2002)≥3 分、营养不良、TNM分期(Ⅲ+Ⅳ期)、肿瘤直径>4 cm、分化程度、淋巴结转移、癌胚抗原(CEA)、糖链抗原125(CA125)和糖类抗原199(CA199)水平与GC病人术前贫血有关(P<0.05～P<0.01);logistic回归分析显示,年龄≥65岁,营养不良和肿瘤直径>4cm是GC病人术前贫血的独立危险因素(P<0.05～P<0.01);与非贫血组相比,贫血组病人术后发热、肺部感染和营养不良并发症明显增加(P<0.05～P<0.01).结论:胃癌病人术前贫血的危险因素较多,其中年龄≥65 岁、营养不良和肿瘤直径>4cm是GC病人术前贫血的独立危险因素;术前贫血增加了病人术后发热、肺部感染及营养不良并发症的发生率.
Abstract
Objective:To investigate the anemic condition of patients with gastric cancer(GC)before operation,its risk factors and its correlation with postoperative complications,so as to provide the evidence for perioperative management.Methods:The perioperative clinical data of 500 GC patients in a tertiary hospital were analyzed,and the anemia condition,risk factors and postoperative complications of GC patients were discussed.Results:Among the 500 patients,212 cases(42.4%)were anemia patients and 288 cases(57.6%)were non-anemia patients.The differences of the age,body mass index(BMI),red blood cell count(RBC),hemoglobin(Hb),red blood cell distribution width(RDW-CV),serum total protein(TP),albumin(Alb),triglyceride(TG)and total cholesterol(TCH)between anemia group and non-anemia group were statistically significant(P<0.01).The results of single factor analysis showed that theage≥65 years,combinedwithchronicobstructive pulmonarydisease,historyof abdominal surgery,BMI<18.5 kg/m2,nutritional risk screening(NRS2002)≥3 scores,malnutrition,TNM stage(Ⅲ+Ⅳ),tumor diameter>4 cm,differentiation degree,lymph node metastasis,and levels of carcinoembryo antigen(CEA),glucose carbohydrate antigen 125(CA125)and carbohydrate antigen 199(CA199)were associated with the preoperative anemia in GC patients(P<0.05 to P<0.01).The results of logistic regression analysis showed that the age≥65 years old,malnutrition and tumor diameter>4 cm were the independent risk factors of preoperative anemia in GC patients(P<0.05 to P<0.01).Compared with the non-anemic group,the complicationa of fever,pulmonary infection and malnutrition significantly increased in the anemia group(P<0.05 to P<0.01).Conclusions:There are many risk factors for preoperative anemia in GC patients.The age≥65 years old,malnutrition and tumor diameter>4 cm are the independent risk factors of preoperative anemia in GC patients.Preoperative anemia increases the incidence of postoperative complications such as fever,pulmonary infection and malnutrition.
基金项目
安徽医科大学科研基金资助项目(2020xkj230)
NETL
NSTL
维普
万方数据