肝细胞癌患者术前营养评估中NRS2002的应用价值

··NＲS2002【】NＲS2002hepatocellularcarcinomaHCC。2013320149NＲS2002HCC703634。ICU、1、3、1、、、P＜0.05、P＞0.05。HCC、NＲS2002HCCHCC。【】NＲS2002【】Ｒ735.7【】A【】1006-4761201406-0410-04TheClinicalValueofNutritionalＲiskAssessment2002inPreoperativeNutritionalAssessmentofPatientsWithHCCZIXue-jianBIANXiao-jieQIUYu-dongetal.TheGulouhospitalofNanjingMedicalUniversityNanjing210000China【Abstract】ToexploretheclinicalvalueofNutritionalＲiskAssessment2002NＲS2002inpreoperativenutritionalassess-mentofpatientswithHCC．Methods70HCCpatientstreatedwithhepatectomyatDrumTowerHospitalfromMarch．2013toSept．2014weredividedintonon-riskNＲgroupn=36andriskＲgroupn=34．PatientsinＲgrouphadnutritionalriskassessedbyNＲS2002beforehepatectomyandpatientsintheNＲgroupdidn’thavenutritionalrisk．Dataofpatientsoftwogroupswerecom-paredwhichincludedexogenousalbumininfusionpostoperativeliverfunctionICUadmissionrateanalexhausttimecomplica-tionslengthofpostoperativestayandthetotalhospitalcosts．ＲesultsThemeanofdataofＲgroupwassignificantlyhigherthanthatofNＲgroupinsuchmarkersasICUadmissionratealanineaminotransferaseALTaspartatetransaminaseASTonday13afterhepatectomydirectbilirubinDBonday1afterhepatectomyexogenousalbumininfusioncomplicationslengthofpostoperativestayandthetotalhospitalcostsP＜0.05．TherewerenosignificantdifferenceofalbuminALBandanalexhausttimebetweentwogroupsP＞0.05．ConclusionPatientswithpreoperativenutritionalriskassessedbyNＲS2002hadworsepostoperativerecover-ylongerpostoperativestayandmorehospitalcosts．NＲS2002forpreoperativenutritionalassessmentinHCCpatientsisfeasibleandeffective．【Keywords】hepatocellularcarcinomaNＲS2002preoperativenutritionassessmentpostoperativerecovery【】ＲC2011003【】210000【】。hepatocellularcarcinomaHCC1。23。Child-Pugh、MELD、ICGCT、MＲIHCC。NＲS2002HCCNＲS2002HCC。11．12013320149HCC。、Child-Pugh、15ICG-Ｒ15。014201412226JournalofHepatobiliarySurgeryVol22No．6Dec．2014、CTMＲI、、、、。。120～752HCC3Child-PughAA4ICG15minICG-Ｒ15≤20%。1Child-PughB～C2ICG-Ｒ15＞20%34、、5、6。70。48NＲS2002。NＲS20023634。1．2。《》。。Pringle。70g/L。ICU。1．2。。12h24h、TPMCT500ml/d31000ml/。HBV-DNA500/ml30g/L。1．3、、、、、、、、ICU1、3、5、、、、。、、、。1．4SPSS19。T±。χ2。。P＜0.05。22．1181836～735010。151939～755412。、、。1。1珋x±sn=36n=34tχ2P/18/1815/190．3430．64150．00±3．0354．70±2．96－1．110．985450．2020．731670．1780．763U/L36．56±9．2443．33±9．54－0．5100．580U/L29．87±4．9036．51±4．47－0．9980．988μmol/L14．11±0．9915．68±0．97－1．1330．738μmol/L4．08±0．294．930±0．50－1．4900．073g/L41．03±0．8737．23±1．092．7420．9752．2318318114201412226JournalofHepatobiliarySurgeryVol22No．6Dec．201490～5952131810～12050～1000ml294ml6600～800mlICU71～2。314320115～6303552015～120200～2000ml520ml10300～1600mlICU181～5。、、、、P＞0.05。ICUP＜0.052。2珋x±sn=36n=34tχ2P0．5490．4823181431820min213．61±28．02355．29±38．84－2．9840．196/18/1820/140．5490．482ml294．44±59．26520．59±112．05－1．8130．216/6/3010/241．6110．260ICU/7/2918/168．5450．006*2．32．3．1、1、3、P＜0.01、P＜0.01P＜0.01、P＜0.05。5、P＞0.05。2．3．2、1P＞0.051P＜0.05。3、5、P＞0.05。2．3．31、3、5P＞0.053。3珋x±sn=36n=34tχ2P1U/L206．11±28．58477．89±126．16－2．1570．000*U/L182．12±27．01475．37±114．48－2．5590．001*μmol/L19．57±2．5224．75±5．28－1．160．296μmol/L6．13±0．7013．47±3．52－2．1000．012*g/L33．34±0．9729．47±1．242．4680．4213U/L170．93±25．41351．85±104．03－1．7340．005*U/L76．77±10．52212．78±93．72－1．4840．016*μmol/L21．76±2．2725．38±5．30－0．6420．054μmol/L8．10±1．2412．81±3．17－1．4160．061g/L36．38±1．3530．24±0．873．7760．6155U/L116．08±15．0149．58±32．07－0．9270．054U/L46．39±5．1848．02±7．90－0．1700．561μmol/L19．38±2．8224．75±5．01－0．9180．219μmol/L7．29±1．2512．72±3．60－1．3900．124g/L36．39±0．8632．01±0．923．4520．5202．4P＜0.01P＞0.05P＜0.05P＜0.054。2．5。211。127A221、、。P＜0.014。4珋x±sn=36n=34tχ2Pg12．92±5．4140．44±14．15－1．8570．003*d2．39±0．203．00±0．17－2．0350．176/2/3412/229．6650．002*d9．11±0．3012．65±0．77－4．3840．011*51915±379663905±6357－1．6640．022*214201412226JournalofHepatobiliarySurgeryVol22No．6Dec．20143。HCC80%4HCCHCC。、、5、6。HCC。NＲS2002、PG-SGA、SGA、MNA。NＲS2002ESPEN20027。NＲS20028、9。NＲS2002、37337。NＲS2002。、、。、、、、。ICU、1、3、1、、。ICU、。10。11。701、。、、、。。HCC、。。NＲS2002HCCHCC、。HCC。HCC、、。1．HCC．200644151070－1074．2FanST．Precisehepatectomyguidedbythemiddlehepaticvein．HepatobiliaryPancreatDisInt200764430－434．3QiuYZhuXZhuＲetal．Theclinicalstudyofprecisehemihepa-tectomyguidedbymiddlehepaticvein．Worldjournalofsurgery201236102428－2435．4KalaitzakisESimrénMOlssonＲetal．Gastrointestinalsymptomsinpatientswithlivercirrhosisassociationswithnutritionalstatusandhealth-relatedqualityoflife．Scandinavianjournalofgastroenterolo-gy200641121464－1472．5CheungKLeeSSＲamanM．Prevalenceandmechanismsofmal-nutritioninpatientswithadvancedliverdiseaseandnutritionman-agementstrategies．ClinicalGastroenterologyandHepatology2012102117－125．6NormanKPichardCLochsHetal．Prognosticimpactofdisease-relatedmalnutrition．Clinicalnutrition20082715－15．7KondrupJＲASMUSSENHHHambergOLEetal．NutritionalriskscreeningNＲS2002anewmethodbasedonananalysisof314201412226JournalofHepatobiliarySurgeryVol22No．6Dec．2014controlledclinicaltrials．Clinicalnutrition2003223321－336．8Badia-TahullMBCobo-SacristánSLeiva-BadosaEetal．Utiliza-cindesubjectiveglobalassessmentpatient-generatedsubjectiveglobalassessmentynutritionalriskscreening2002paraevaluareles-tadonutricio