【摘要】 目的：在肝癌肝切除术病人中探索标准化相位角(SPA)与手术临床结局的关联，分析其与营养评估方法的关联。方法：本研究是一项前瞻性研究，纳入107例接受手术治疗的肝癌病人，术前对病人进行生物电阻抗分析、患者主观整体评估（PG-SGA）、人体测量等多项检测，按照SPA 25%、50%为截断值比较病人的基本资料。使用Logistic回归分析SPA与不同营养评估指标的关系，并分析出现术后并发症和术后住院时间延长的危险因素。结果：PG-SGA评估营养不良者(≥4分)占36.8%，低SPA组术前营养评估指标较差，握力较低，且术后二级及以上并发症发生率较高（P <0.05）。低25%SPA病人使用NRS 2002 (OR=3.38, 95%CI:1.32～8.65)、PG-SGA(OR=3.04,95%CI:1.19～7.56)和PNI (OR=3.75, 95%CI:1.27～11.11)评估为有营养风险和营养不良可能性更高，且握力(OR=8.40, 95%CI:2.16～32.67)较低；低50%SPA仅与PG-SGA(≥4)评估营养不良和低握力相关。多因素Logistic分析结果显示，低25%SPA(OR=3.45,95%CI:1.29～9.21)和手术时长（> 180 min）(OR=4.06,95%CI:1.08～11.97)是术后并发症发生的独立危险因素(P <0.05)，只有手术时长（> 180 min）(OR=3.42;95%CI:1.14～10.30)是术后住院时间延长的危险因素（P=0.03）。结论：在肝癌肝切除术病人中，SPA与多种营养评估方法的结果相关，低25%SPA是术后出现并发症的危险因素之一。更多还原

【Abstract】 Objective: To investigate the associations between standardized phase angle(SPA) and clinical outcomes in patients undergoing hepatectomy for liver cancer, and analyzed its association with nutritional status.Methods: This prospective observational study included 107 patients undergoing hepatectomy. Before surgery, patients were subjected to multiple nutritional assessments, including bioelectrical impedance analysis, Patient-Generated Subjective Global Assessment(PG-SGA), anthropometric measurements and so on. The basic data of patients were compared between groups according to the cut-off values of 25% and 50% of SPA. Logistic analysis was used to analyze the associations between SPA and different nutrition status parameters. And then the risk factors for the incidences of significant postoperative complications and prolonged hospitalization were investigated. Results: The prevalence of malnutrition was 36.8% according to PG-SGA(≥ 4). In the low SPA group, preoperative nutritional evaluation results were worse, grip strength was lower, and the incidence of postoperative complications was higher(P < 0.05). Patients with SPA below 25% had a greater chance of being diagnosed as malnourished according to NRS-2002(OR = 3.38,95% CI: 1.32 8.65), PG-SGA(≥ 4)(OR = 3.04, 95%CI: 1.19 ～ 7.56) and PNI(≤ 45)(OR = 3.75, 95% CI: 1.27 ～ 11.11),and were more likely had lower grip strength(OR = 8.40, 95%CI: 2.16 ～ 32.67). Only PG-SGA(≥ 4) evaluations of malnutrition and lower grip strength were linked to patients with SPA below 50%. Multivariate Logistic analysis showed that 25%SPA(OR = 3.45; 95%CI: 1.29 ～ 9.21) and operation duration(> 180 min)(OR = 4.06; 95%CI 1.08 ～ 11.97)were independent risk factors for postoperative complications(P < 0.05), and only operation duration(> 180min)(OR =3.42; 95%CI 1.14 ～ 10.30) was an independent risk factor for prolonged hospitalization(P = 0.03). Conclusion: In patients undergoing hepatectomy for liver cancer, SPA was associated with multiple nutritional assessment outcomes.SPA below 25% is a risk factor for significant postoperative complications.更多还原