摘要
目的探究预后营养指数(prognostic nutritional index,PNI)在达芬奇机器人食管癌McKeown术后并发症中的应用价值。方法回顾性分析兰州大学第一医院胸外科2019年1月—2022年6月行达芬奇机器人食管癌McKeown手术的食管癌患者的临床资料。根据受试者工作特征曲线探究PNI预测术后并发症的最佳截断值,根据截断值将患者分为两组:高PNI组和低PNI组。分析两组患者之间的基本特征和手术相关指标及术后并发症的差异。根据患者是否发生术后并发症分为无并发症组和有并发症组,通过单因素和多因素分析探讨相关指标对达芬奇机器人食管癌McKeown术后并发症发生的影响。结果120例患者纳入研究,其中男95例、女25例,平均年龄(62.82±7.82)岁。高PNI组术前血红蛋白含量、术前血淋巴细胞计数、术前血白蛋白量和术前血总胆固醇量均高于低PNI组,差异有统计学意义(P<0.05)。高PNI组与低PNI组的术后总体并发症发生率、肺部感染率、胸腔积液发生率和切口愈合不良发生率差异有统计学意义(P<0.05)。将可能引起术后并发症的相关指标纳入单因素分析,结果提示年龄、手术时间、术中出血量、术前血淋巴细胞计数、术前血红蛋白含量、术前血单核细胞计数、术前血白蛋白量和PNI是达芬奇机器人食管癌McKeown术后并发症的可能影响因素。将这些影响因素纳入多因素分析,结果提示年龄、PNI、手术时间和术中出血量是术后并发症的独立影响因素。结论PNI在达芬奇机器人食管癌McKeown术后并发症中具有一定的预测价值,PNI为术后并发症的独立影响因素,术前提高食管癌患者的PNI水平或有助于减少术后并发症的发生。
Objective To explore the application value of prognostic nutritional index(PNI)in the postoperative complications of McKeown surgery for da Vinci robotic esophageal cancer.Methods The clinical data of the patients who underwent da Vinci robotic McKeown surgery for esophageal cancer in the Department of Thoracic Surgery of the First Hospital of Lanzhou University from January 2019 to June 2022 were retrospectively collected.According to the receiver operating characteristic(ROC)curve,the optimal cut-off value of PNI for predicting postoperative complications was explored.The patients were divided into a high PNI group and a low PNI group according to the cut-off value,and the differences in basic characteristics,surgery-related indexes and postoperative complications between the two groups were analyzed.According to the occurrence of postoperative complications,the patients were divided into a non-complication group and a complication group.Univariate and multivariate analyses were used to explore the influence of relevant indicators on the occurrence of postoperative complications in da Vinci robotic McKeown surgery for esophageal cancer.Results Finally 120 patients were collected,including 95 males and 25 females,with an average age of 62.82 years.The preoperative hemoglobin content,preoperative blood lymphocyte count,preoperative serum albumin and preoperative blood total cholesterol in the high PNI group were higher than those in the low PNI group(P<0.05).There were statistical differences between the two groups in the incidences of postoperative overall complications,pulmonary infection,pleural effusion and poor incision healing(P<0.05).The relevant indicators that may cause postoperative complications were included in univariate analysis,and the results showed that age,operation time,intraoperative blood loss,preoperative blood lymphocyte count,preoperative hemoglobin content,preoperative blood mononuclear cell count,preoperative blood monocyte count,serum albumin level and PNI were possible influencing factors of postoperative complications after da Vinci robotic McKeown surgery for esophageal cancer.Incorporating these influencing factors into multivariate analysis,the results showed that age,PNI,operation time and intraoperative blood loss were independent influencing factors of postoperative complications.Conclusion PNI has certain predictive value in the postoperative complications of da Vinci robotic McKeown surgery for esophageal cancer.PNI is an independent factor affecting postoperative complications.Improving the level of PNI in esophageal cancer patient before surgery may help reduce the occurrence of postoperative complications.
作者
梁秋豪
马敏杰
蔺瑞江
王晨晗
韩志伟
韩彪
LIANG Qiuhao;MA Minjie;LIN Ruijiang;WANG Chenhan;HAN Zhiwei;HAN Biao(The First Clinical Medical College of Lanzhou University,Lanzhou,730000,P.R.China;Department of Thoracic Surgery,The First Hospital of Lanzhou University,Lanzhou,730000,P.R.China;Major in Research and Development and Application of Key Technologies in Thoracic Surgery Gansu International Science and Technology Cooperation Base,Lanzhou,730000,P.R.China;Gansu Provincial Medical Quality Control Center of Thoracic Surgery,Lanzhou,730000,P.R.China)
出处
《中国胸心血管外科临床杂志》
CSCD
北大核心
2024年第3期376-384,共9页
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery
基金
甘肃省青年科技基金(21JR1RA107)
甘肃省自然科学基金(21JR1RA118)。
关键词
预后营养指数
达芬奇机器人
食管癌McKeown手术
术后并发症
Prognostic nutritional index
da Vinci robot
McKeown surgery for esophageal cancer
postoperative complications
作者简介
通信作者:韩彪,Email:hanbiao66@163.com。
