【摘要】 背景:老年溃疡穿孔患者术后并发症发生风险高,既往缺乏有效的预测方法。营养风险评估通过给予有营养风险的患者营养支持治疗,可改善临床结局,减少并发症的发生率。目的:探讨营养风险评估对老年胃十二指肠溃疡穿孔患者术后并发症的预测价值。方法:选取2015年1月—2017年12月暨南大学附属河源市人民医院的100例老年胃十二指肠溃疡穿孔患者,分别采用NRS-2002评分、SGA评分进行营养风险评估,记录术后并发症发生情况,并采用多因素Logistic回归分析探讨术后并发症发生的危险因素。结果:NRS-2002评分示无营养风险37例,具有营养风险63例; SGA评分示无营养不良41例,中度营养不良32例,重度营养不良27例。两组无营养不良/营养风险比例差异无统计学意义(P> 0. 05)。共21例患者发生不同程度的并发症。NRS-2002、SGA评分与严重并发症、感染性并发症的发生率相关(P <0. 05)。多因素Logistic回归分析结果显示,NRS-2002、SGA评分均为老年胃十二指肠溃疡穿孔术后并发症的独立危险因素(P <0. 05)。结论:NRS-2002评分和SGA评分均可评估老年胃十二指肠溃疡穿孔患者的营养不良状况,且与术后并发症发生密切相关,可用于预测术后并发症的发生风险。更多还原

【Abstract】 Background: There is a high risk of postoperative complication of ulcer perforation in senile patients,and there is no effective predictive method previously. Nutritional risk assessment improves clinical outcome and reduces the incidence of complication by receiving nutritional support treatment for patients at risk of nutrition. Aims: To investigate the predictive value of nutritional risk assessment for postoperative complication in elderly patients with gastroduodenal ulcer perforation.Methods: A total of 100 patients with perforation of gastroduodenal ulcer from January 2015 to December 2017 at Heyuan People’s Hospital Affiliated to Jinan University were enrolled. NRS-2002 score and SGA score were used for nutritional risk assessment. The occurrence of postoperative complication was recorded,and risk factors of postoperative complication were analyzed by multivariate Logistic regression analysis. Results: NRS-2002 score showed that no nutritional risk in 37 patients,63 patients with nutritional risk. SGA score showed that no malnutrition was found in 41 patients,moderate malnutrition in 32 patients,and severe malnutrition in 27 patients. There was no significant difference in the proportion of no malnutrition/nutritional risk between the two groups( P > 0. 05). Different degrees of complication occurred in 21 patients. NRS-2002 score and SGA score were correlated with the incidence of serious complication and infectious complication( P < 0. 05). Multivariate Logistic regression analysis showed that NRS-2002 score and SGA score were independent risk factors for postoperative complication of gastroduodenal ulcer perforation( P < 0. 05). Conclusions: NRS-2002 score and SGA score can be used to assess malnutrition in elderly patients with perforation of gastroduodenal ulcer.NRS-2002 score,SGA score are closely related to postoperative complication,and can be used to predict the risk of postoperative complication.更多还原