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营养状况对经过最小侵入性胰腺脱术后短期预后的影响
Zheyu Xu1,2, Jingtao Chen1,2, Yiping Mou1,3
1Department of Gastroenterology & Pancreatic Surgery, Zhejiang Province People's Hospital, Hangzhou, 310000, Zhejiang, People's Republic of China.
Scientific reports
|November 28, 2024
概括
手术前的sarcopenia,肌肉损失的一种衡量标准,显著增加了微创胰腺管切除术 (MIPD) 后并发症和发病率的风险. 营养评估,包括皮病查,对于改善MIPD后患者的治疗结果至关重要.
科学领域:
- 手术瘤学手术瘤学
- 胃肠病学 胃肠病学
- 营养科学 营养科学
背景情况:
- 最少侵入性胰腺双管切除术 (MIPD) 是治疗瘤的标准程序.
- 营养不良与增加的手术发病率和死亡率有关.
- 手术前营养状况对MIPD结果的影响尚未得到充分证实.
研究的目的:
- 调查手术前营养状况与MIPD后的短期结果之间的关联.
- 识别可能影响术后预后的特定营养因素,如肉症.
主要方法:
- 对207名接受MIPD的患者进行了回顾性分析.
- 在手术前进行多维营养评估.
- 多变量分析和倾向性得分匹配 (PSM) 来评估结果.
主要成果:
- 在多变量分析中,肉症与术后发病率 (OR 9.74) 和重大并发症 (OR 6.74) 的增加显著相关.
- 在PSM之后,肉症仍然是患病率 (OR 12.44) 和重大并发症 (OR 8.14) 的独立预测因素.
- 评估的结果包括发病率-死亡率,Clavien-Dindo分类≥IIIa,胰腺,胆管.
结论:
- 手术前的肉症会对MIPD后的短期结果产生负面影响.
- 常规的手术前营养评估,专注于肉症,建议MIPD患者.
- 早期的营养支持可能会减轻风险并改善术后预后.
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