【摘要】 目的基于ESPEN标准,探讨营养风险评估表(NRS-2002)、营养不良通用筛查表(MUST)、患者主观整体评估表(PG-SGA)、控制营养状态评分(CONUT)评估肝细胞肝癌患者术前营养状态并进一步探讨与预后相关性。方法选取我院在2014年1月至2017年1月期间就诊的245例(hepatocellular carcinoma,HCC)患者。所有患者营养筛查于入院24 h内进行。收集NRS-2002、MUST、PG-SGA、CONUT分数。结果 NRS-2002、MUST、PG-SGA、CONUT与ESPEN标准的Kappa值分别为:0.339、0.426、0.483、0.483。多因素Cox比例风险回归显示:BMI、肝硬化(是)、肿瘤分期(Ⅱ-Ⅲ)、PG-SGA(营养不良)、CONUT(营养不良)是HCC患者复发的独立危险因素(P<0.05);肝硬化(是)、PG-SGA(营养不良)、CONUT(营养不良)是HCC患者死亡的独立危险因素(P<0.05)。结论 PG-SGA、CONUT均可以作为HCC患者术前营养筛查工具并与术后复发及死亡存在联系。但是PG-SGA临床运用繁琐及CONUT的一致性较高,推荐采用CONUT进行营养筛查工具。更多还原

【Abstract】 Objective To evaluate the nutritional risk assessment form(NRS-2002),the malnutrition universal screening form(MUST),the patient subjective overall assessment form(PG-SGA),and the controlled nutritional status score(CONUT) to evaluate liver based on ESPEN standards.The preoperative nutritional status of patients with hepatocellular carcinoma and further explore its correlation with prognosis.Methods A total of245 patients with HCC who were treated in our hospital from January 2014 to January 2017 were selected.All patients were screened for nutrition within 24 hours of admission.Collect NRS-2002,MUST,PG-SGA,and CONUT scores.Results The Kappa values of NRS-2002,MUST,PG-SGA,CONUT and ESPEN standards are:0.339,0.426,0.483,0.483.Multivariate Cox proportional hazard regression showed that BMI,liver cirrhosis(yes),tumor staging(Ⅱ-Ⅲ),ESPEN standard(malnutrition),PG-SGA(malnutrition),and CONUT(malnutrition) were independent risk factors for recurrence in HCC patients(P <0.05) C.irrhosis(yes),ESPEN standard(malnutrition),PG-SGA(malnutrition),and CONUT(malnutrition) were independent risk factors for death in patients with HCC(P <0.05).Conclusion Both PG-SGA and CONUT can be used as preoperative nutrition screening tools for HCC patients,and they are related to postoperative recurrence and death.However,the clinical application of pg-sga is complicated and the consistence of conut is high.It is recommended to use conut as a nutritional screening tool.更多还原