| Objective:Through the investigation of preoperative application of nutritional risk screening 2002(NRS2002),subjective global assessment(SGA)and mini nutritional assessment(MNA)in the preoperative colorectal cancer patients and the investigation of the relationship between the nutritional risk screening and the nutritional risk incidence,nutrition support,postoperative complications,the feasible nutritional screening method was found for the hospital colorectal cancer patients.In order to help surgeons make accurate nutritional evaluation in the early stage of admission to patients with colorectal cancer,timely and effective nutritional support for patients with nutritional requirements is given to improve the patient's adverse outcome.Methods:This is a prospective cohort study.From January 2016 to December 2017 in the Chao yang Central Hospital affiliated to Cheng de Medical College,the colorectal cancer patients were collected as the research object.In accordance with the inclusion criteria,the 3 methods of NRS2002,SGA and MNA of were finished within 24 hours of admission.The pathological inclusion criteria were:(1)the age of the patients was 18~80 years old,the length of stay was over 24 hours,and no emergency operation was performed before 8 days after the next day,with clear mind and informed consent.(2)preoperative colonoscopic biopsy,diagnosis for colon or rectal cancer;(3)without serious damage to the heart,liver,kidney,lung and other organs before surgery and cachexia;(4)All patients underwent radical elective surgery;(5)no mental diseases and voluntary cooperation questionnaire before the operation,can communicate with normal language.The data of nutritional screening were recorded as a registration form including the preoperative nutritional risk assessment results,preoperative nutritional support status,postoperative complications and clinical outcomes.WPS Office 2016 is used to establish a database,and the data is analyzed with IBM SPSS 19 statistics software.The ratio of preoperative nutritional screening and postoperative complications was compared with the x 2 test.The difference was statistically significant with the difference of P < 0.05.The postoperative complication risk,using logistic regression analysis,and draw the screening method of preoperative nutrition on subjects to predict postoperative complications of operating characteristic curve(ROC curve),by comparing the painting area under the curve(AUC),with different screening methods to measure the preoperative nutrition in prediction the postoperative complications of the value.Conformance test(kappa value)was used to examine the degree of anastomosis between three nutritional screening methods.Results:According to the above inclusion criteria,150 patients were enrolled in the study.There were 87 male patients and 63 female patients.The oldest patient was 80 years old,the youngest one was 42 years old,and the average age of the patients was 62.1 years old.There were 44 cases of colon cancer(29.33%),transverse colon in 15 cases(10%),24 cases of descending colon(16%),25 cases of sigmoid colon(16.67%),42 cases of rectal cancer(28%),respectively.The 3 nutritional risk screening methods of NRS2002,SGA and MNA were used for the preoperative nutrition screening and risk assessment.In according to the NRS2002 standard,the preoperative nutritional risk patients were 68(45.33%),82 patients without nutritional risk(54.67%);according to the SGA standard: 27 cases of severe malnutrition(18%),56 cases of mild to moderate malnutrition(37.33%),no 67 cases of malnutrition(44.67%);according to the MNA score standard: 43 cases of malnutrition(28.67%),48 cases of the potential malnutrition(32%),59(39.33%)cases of normal nutrition.Postoperative complications occurred in 31 out of 150 patients with colorectal cancer(20.67%).According to the screening score of three preoperative NRS2002,SGA,and MNA screening methods,the results of the three screening methods were closely related to the overall complications and infectious complications after the operation(P < 0.05),but the incidence of postoperative minor complications and non infectious complications was statistically meaningless(P > 0.05)only NRS2002 in the three screening methods is closely related to the occurrence of postoperative moderate to severe complications(P < 0.05).The analysis of logistic regression analysis showed that NRS2002 could independently predict postoperative complications of colorectal cancer patients.The consistency of NRS2002 and SGA in patients with colorectal cancer was higher than that of NRS2002 and MNA(0.802:0.699).Conclusion:1.the application of traditional single nutritional evaluation index in patients with large bowel cancer has its limitations,which can not reflect the true nutritional status of the patients with large intestine cancer.2.the three commonly used nutritional screening methods,the application of NRS2002 in the patients with large intestine cancer has good feasibility and stability.It can judge the nutritional risk of the patients early,and recommend the first choice in the patients who are hospitalized for large bowel cancer.3.MNA and SGA are also helpful in judging the nutritional status of patients with large intestine cancer in the operation,and can be used as an auxiliary tool of NRS2002 in patients with large intestine cancer. |
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