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内脏脂肪面积对结直肠癌患者围手术期相关指标及短期预后的影响

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目的 探讨内脏脂肪面积(VFA)对结直肠癌患者围手术期相关指标及短期预后的影响。方法 回顾性分析2020年9月至2023年8月在包头医学院第一附属医院行腹腔镜下结直肠癌根治术的102例患者的临床资料。所有患者术前均行腹部CT检查,选取第3腰椎(L3)横截面CT图像,采用Slice-O-Matic软件测定VFA,根据测量结果分为高VFA组(VFA≥100 cm2)和低VFA组(VFA<100 cm2)。收集患者临床资料、病理资料、手术资料、术后并发症及围手术期的凝血和炎症指标。结果 与低VFA组比较,高VFA组BMI、住院时间、术中出血量更多,淋巴结清扫数量更少(P<0。05)。高VFA组手术前后WBC、术后降钙素原(PCT)高于低VFA组(P<0。05)。与术前比较,术后两组WBC、C反应蛋白(CRP)、PCT、血浆凝血酶原时间(PT)、血浆纤维蛋白原(FIB)、国际标准化比率(INR)升高,PLT下降,差异有统计学意义(P<0。05);术后高VFA组活化部分凝血酶原时间(APTT)下降,低VFA组凝血酶时间(TT)下降,差异有统计学意义(P<0。05)。高VFA组术后并发症总发生率(21。2%)高于低VFA组(4。0%),切口并发症发生率(15。4%)高于低VFA组(2。0%),差异有统计学意义(P<0。05)。结论 高VFA结直肠癌围手术期患者有更高的炎症水平,预后更差。
Influence of visceral fat area on perioperative indicators and short-term prognosis in patients with colorectal cancer
Objective To investigate the effect of visceral fat area (VFA) on perioperative related indi-cators and short-term prognosis of patients with colorectal cancer (CRC).Methods Clinical data of 102 pa-tients who underwent laparoscopic radical surgery for CRC in the First Affiliated Hospital of Baotou Medical College from September 2020 to August 2023 were retrospectively analyzed.All patients underwent preopera-tive abdominal CT examination,and the transverse CT images at the level of the third lumbar vertebra (L3) were selected.VFA was measured using Slice-O-Matic software,and patients were divided into the high VFA group (VFA≥100 cm2) and the low VFA group (VFA<100 cm2) based on the measurement results.Clinical data,patho-logical data,surgical data,postoperative complications,and perioperative coagulation and inflammation indicators were collected.Results Compared with the low VFA group,the high VFA group had higher BMI,longer hospital stay,greater intraoperative blood loss,and fewer lymph node dissections (P<0.05).The WBC and PCT lev-els before and after surgery in the high VFA group were higher than those in the low VFA group (P<0.05). Compared with preoperative levels,WBC,C-reactive protein (CRP),PCT,plasma prothrombin time (PT), plasma fibrinogen (FIB),and international standardized ratio (INR) increased and PLT decreased in both groups after surgery,the differences were statistically significance (P<0.05);Compared with preoperative conditions,the activated partial prothrombin time (APTT) in the high VFA group and the thrombin time (TT) decreased in the low VFA group decreased after surgery,the differences were statistically significant (P<0.05).The total incidence of postoperative complications (21.2%) and the incidence of incision compli-cations (15.4%) in the high VFA group were higher than that in the low VFA group (4.0%,2.0%),the differences were statistically significant (P<0.05).Conclusion Colorectal cancer patients with high VFA during the perioperative period exhibit higher levels of inflammation indicators and poorer prognosis.

colorectal cancervisceral fat areashort-term prognosisinflammatory indicatorscoagulation indicators

陈会文、马兴越、刘锦裕、国强

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包头医学院,内蒙古包头 014040

包头医学院第一附属医院胃肠外科,内蒙古包头 014010

结直肠癌 内脏脂肪面积 短期预后 炎症指标 凝血指标

2024

重庆医学
重庆市卫生信息中心,重庆市医学会

重庆医学

CSTPCD
影响因子:1.797
ISSN:1671-8348
年,卷(期):2024.53(9)