中国实用外科杂志

中国实用外科杂志

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预后营养指数对老年病人肝癌切除术后腹腔感染预测价值研究

李    超a，com/zgsywk/CN/article/advancedSearchResult.do?searchSQL=(((c[Author]) AND 1[Journal]) AND year[Order])" target="_blank">com/zgsywk/CN/articom/zgsywk/CN/article/advancedSearchResult.do?searchSQL=(((c[Author]) AND 1[Journal]) AND year[Order])" target="_blank">cle/advancom/zgsywk/CN/article/advancedSearchResult.do?searchSQL=(((c[Author]) AND 1[Journal]) AND year[Order])" target="_blank">cedSearcom/zgsywk/CN/article/advancedSearchResult.do?searchSQL=(((c[Author]) AND 1[Journal]) AND year[Order])" target="_blank">chResult.do?searcom/zgsywk/CN/article/advancedSearchResult.do?searchSQL=(((c[Author]) AND 1[Journal]) AND year[Order])" target="_blank">chSQL=(((苗润晨b[Author]) AND 1[Journal]) AND year[Order])" target="_blank">苗润晨b，com/zgsywk/CN/article/advancedSearchResult.do?searchSQL=(((c[Author]) AND 1[Journal]) AND year[Order])" target="_blank">c，com/zgsywk/CN/article/advancedSearchResult.do?searchSQL=(((张靖垚b[Author]) AND 1[Journal]) AND year[Order])" target="_blank">张靖垚b，com/zgsywk/CN/article/advancedSearchResult.do?searchSQL=(((c[Author]) AND 1[Journal]) AND year[Order])" target="_blank">c，刘    昌b   

  1. 西安交通大学第一附属医院 a.普通外科 b.肝胆外科c.SICU，陕西西安 710061
  • 出版日期:2019-06-01 发布日期:2019-06-12

  • Online:2019-06-01 Published:2019-06-12

摘要：

目的    探讨预后营养指数（PNI）对老年肝癌切除术后病人发生腹腔感染的预测价值。方法    回顾性分析西安交通大学第一附属医院收治的270例行手术切除治疗老年原发性肝癌病例资料。采用受试者工作曲线（ROC）、多因素分析及生存曲线确定术前PNI对术后腹腔感染的预测价值。结果    共筛选出34例腹腔感染病人，累积发生率为12.59%（34/270）。术前PNI预测术后并发腹腔感染的最佳截断值为47.58（P＜0.05）。合并糖尿病、贫血及PNI＜47.58是肝癌切除术后并发腹腔感染的独立危险因素（P＜0.05）。PNI＜47.58的腹腔感染病人术后近期总体存活率和无复发存活率均较低，但差异无统计学意义（P＞0.05）。结论    术前PNI对老年肝癌切除术后病人并发腹腔感染具有一定的预测价值。

关键词: 预后营养指数, 老年病人, 原发性肝癌, 腹腔感染

Abstract:

The predictive value of PNI for post-operative intra-abdominal infections in gerontal liver cancer patients                 LI Chao*, MIAO Run-chen, ZHANG Jing-yao, et al.*Department of General Surgery, the First Affiliated Hospital of Xi’an Jiaotong University, Xi’an 710061, China
Corresponding author：LIU Chang，E-mail：liuchangdoctor@163.com
Abstract    Objective    To investigate the predictive significance of prognostic nutritional index (PNI) for intra-abdominal infections(IAIs) in gerontal liver cancer patients who received hepatectomy. Methods    The clinical data of 270 gerontal (age≥60y) patients with primary liver cancer (PLC) who received hepatectomy in the First Affiliated Hospital of Xi’an Jiaotong University were retrospectively analyzed. Receiver operating characteristic curve (ROC), multivariate analysis and survival curve were used to conduct the predictive significance of preoperative PNI for IAIs.Results    The incidence of IAIs was 12.59% (34/270) in this cohort. The cut-off value of preoperative PNI for the prediction of postoperative IAIs was 47.58 (P<0.05). Patients with diabetes mellitus, anemia and PNI<47.58 were demonstrated as the independent risk factors for postoperative IAIs (P<0.05, respectively). Patients with PNI<47.58 suffered lower but not significantly short-term over-all and disease-free survival rate (P>0.05). Conclusion    Preoperative PNI determination has predictive value for postoperative IAIs in gerontal liver cancer patients who received hepatectomy.

Key words: prognostic nutritional index, gerontal patient, primary liver cancer, intra-abdominal infections(IAIs)