胃癌患者术后营养管理方案调查和衰弱发生调查及其影响因素分析OA
Investigation of Postoperative Nutrition Management and Frailty in Gastric Cancer Patients and Analysis of Influencing Factors
目的 调查胃癌患者术后营养管理方案及衰弱发生情况,并分析衰弱发生的影响因素.方法 采用简单随机抽样法,选取2024年6月至2025年11月南京医科大学附属淮安第一医院收治的223例胃癌手术患者.统计患者术后早期营养管理方案及衰弱发生情况,根据胃癌术后1个月衰弱发生情况分为衰弱组(105例)和非衰弱组(118例).比较两组临床资料,采用多因素Logistic回归分析胃癌患者术后衰弱发生的影响因素.结果 本研究共纳入223例胃癌患者,术后135例(60.54%)患者行肠内营养(EN)支持,88例(39.46%)患者行EN联合肠外营养(PN)支持.在EN置管方式中,68例(30.49%)为经口置管,52例(23.32%)为造瘘置管,103例(46.19%)为鼻空肠管置管.223例胃癌患者中,36例(16.14%)术前存在衰弱,105例(47.09%)患者在胃癌术后1个月发生衰弱,胃癌患者术后1个月衰弱发生率高于术前.衰弱组与非衰弱组年龄、体质量指数、婚姻状态、合并慢性病、术前营养风险、术前衰弱、肿瘤直径、术前新辅助治疗、术前白蛋白水平、术中出血量、术后并发症及术后早期营养支持方式比较,差异有统计学意义(P<0.05).多因素Logistic回归分析结果显示,年龄、体质量指数、合并慢性病、术前营养风险、术前衰弱、术前新辅助治疗、术后并发症及术后早期营养支持方式是胃癌患者术后衰弱发生的影响因素(P<0.05).结论 胃癌患者术后以EN、EN联合PN为主要营养支持方式,且术后衰弱发生率高,年龄、体质量指数、合并慢性病、术前营养风险、术前衰弱、术前新辅助治疗、术后并发症及术后早期营养支持方式是胃癌患者术后衰弱发生的影响因素.
Objective To investigate the postoperative nutrition management scheme and the incidence of frailty in patients with gastric cancer,and to analyze the influencing factors for frailty.Methods Using a simple random sampling method,223 patients with gastric cancer who underwent surgical treatment at the Affiliated Huaian No.1 People's Hospital of Nanjing Medical University from June 2024 to November 2025 were selected.The early postoperative nutrition management schemes and the occurrence of frailty were statistically analyzed.Patients were divided into a frailty group(105 cases)and a non-frailty group(118 cases)based on the occurrence of frailty one month after gastric cancer surgery.Clinical data were compared between the two groups,and multivariate logistic regression analysis was used to identify the influencing factors for postoperative frailty in these patients.Results A total of 223 patients with gastric cancer were included in this study.Postoperatively,135 patients(60.54%)received enteral nutrition(EN)support,and 88 patients(39.46%)received EN combined with parenteral nutrition(PN)support.Regarding the EN tube placement methods,68 patients(30.49%)underwent oral intubation,52 patients(23.32%)underwent fistula catheterization,and 103 patients(46.19%)underwent nasojejunal tube placement.Among the 223 patients,36(16.14%)had preoperative frailty,and 105 patients(47.09%)developed frailty one month after surgery.The incidence of frailty one month after gastric cancer surgery was higher than that before surgery.Statistically significant differences were found between the frailty group and the non-frailty group in terms of age,body mass index(BMI),marital status,comorbid chronic diseases,preoperative nutritional risk,preoperative frailty,tumor diameter,preoperative neoadjuvant therapy,preoperative albumin level,intraoperative blood loss,postoperative complications,and early postoperative nutritional support method(P<0.05).Multivariate logistic regression analysis showed that age,BMI,comorbid chronic diseases,preoperative nutritional risk,preoperative frailty,preoperative neoadjuvant therapy,postoperative complications,and early postoperative nutritional support method were significant influencing factors for postoperative frailty in patients with gastric cancer(P<0.05).Conclusion EN and EN combined with PN are the main nutritional support methods for patients after gastric cancer surgery,and the incidence of postoperative frailty is high.Age,BMI,comorbid chronic diseases,preoperative nutritional risk,preoperative frailty,preoperative neoadjuvant therapy,postoperative complications,and early postoperative nutritional support method are influencing factors for postoperative frailty in these patients.
顾洋洋;朱彤;庄静;徐玲;吴杰;张帆;李春
南京医科大学附属淮安第一医院肿瘤内科,江苏 淮安 223300南京医科大学附属淮安第一医院肿瘤内科,江苏 淮安 223300南京医科大学附属淮安第一医院肿瘤内科,江苏 淮安 223300南京医科大学附属淮安第一医院肿瘤内科,江苏 淮安 223300南京医科大学附属淮安第一医院肿瘤内科,江苏 淮安 223300南京医科大学附属淮安第一医院肿瘤内科,江苏 淮安 223300南京医科大学附属淮安第一医院肿瘤内科,江苏 淮安 223300
胃癌术后营养管理衰弱影响因素
gastric cancerpostoperativenutrition managementfrailtyinfluencing factors
《转化医学杂志》 2026 (5)
758-764,7
江苏省卫生健康委员会科研项目(M2022121)
评论