Evaluation Of The Combination Of ICGR15 And NRS-2002 On The Postoperative Recovery In Patients With Primary Liver Cancer

Objective:To detect the liver reserve function and assess the nutrition of patients with primary liver cancer（PLC）before surgery with the application of Indocyanine Green Retention Rate At 15 min（ICGR15）and Nutritional Risk Screening（NRS-2002）assessment scale,to observe and compare postoperative recovery indicators,so as to provide a theoretical basis for the clinical treatment and postoperative rehabilitation of liver cancer patients.Methods:A total of 223 patients with primary liver cancer who was operated with hepatectomy at the Affiliated Hospital of Guilin Medical College during January 1,2010 to December 31,2016 and accorded with the inclusive criteria were selected.According to the NRS-2002 assessment scale,there were 104 patients with nutritional risk（case group）and 119 patients without nutritional risk（control group）.According to ICGR15<10%,10²0%,>20%,each group is divided into three subgroups.The evacuation time,defecation time,drainage tube placement days,wound healing time,postoperative adverse reaction rate,incidence rate of postoperative complications,the hospitalization days and the hospitalization cost of patients in each group were observed.Measurement data between the group with nutritional risk and the group without nutrition risk were compared by t test,and count data rate was compared by using x² test.P<0.05 indicated the difference was statistically significant.The correlation between ICGR15 and NRS-2002 score was analyzed by Spearman correlation coefficient.Measurement data among ICGR15<10%,10²0%,>20%three subgroups were compared using the variance analysis,and subgroups were compared using SNK-q（Studen-t-Newman-Keuls）method,P<0.05 indicated the difference was statistically significant;the count data was compared using x²test,and the comparison between subgroups was conducted using Bonferroni method,P<0.05 indicated the difference was statistically significant.Results:There were no statistical differences in age,gender,tumor location,tumor diameter,portal vein thrombosis,HBsAg positive rate and tumor resection range between patients of the two groups（P>0.05）;The evacuation time,the defecation time,the days of drainage tube,the time of wound healing and the time of hospitalization in group without nutrition risk were shorter than that of the group with nutrition risk,and the hospitalization cost was also less.P<0.05 indicated that the difference was statistically significant.The incidence of postoperative adverse reactions and postoperative complications in group without nutrition risk was lower than that of the group with nutrition risk.（P>0.05）indicated there was no significant difference between the two groups.When ICGR15<20%,the liver reserve function was not correlated with NRS-2002 score（r=0.194）,（P<0.05）,when ICGR15≥20%,the liver reserve function was positively correlated with NRS-2002 score（r=0.0.647）,（P<0.05）,and the correlation was moderate.In the group with nutrition risk,the incidence of postoperative evacuation time,the defecation time,the time of drainage tube placement,the time of wound healing,the incidence of postoperative adverse reactions,the incidence of postoperative complications and the length of hospitalization extended gradually along with the enhancement of ICGR15,and the hospitalization cost was also increased.（P<0.05）indicated the difference was statistically significant.In the group without nutrition risk,the incidence of postoperative evacuation time,the defecation time,the time of drainage tube placement,the time of wound healing and the length of hospitalization extended gradually along with the enhancement of ICGR15,and the hospitalization cost was also increased.（P<0.05）indicated the difference was statistically significant.With the enhancement of ICGR15,the difference of the incidence of postoperative adverse reactions and the incidence of postoperative complications between the ICGR15<10%group and ICGR15 10²0%group was not statistically significant（P>0.05）,but between the ICGR15<10%group and ICGR15>20%group,between ICGR15 10²0%group and ICGR15>20%group,the difference was statistically significant（R=0.194）,（P<0.05）.Conclusion（s）:The more optimized the nutritional status in patients with liver cancer,the shorter the postoperative evacuation time,the defecation time,the time of drainage tube placement,the time of wound healing and the length of hospitalization is shorter,and the lower the hospitalization cost.When ICGR15>20%and malnutrition exists,the incidence for postoperative complications was high.