广东医学2025，Vol.46Issue(11)：1741-1746,6.DOI:10.13820/j.cnki.gdyx.20251322
控制营养状态评分对COPD食管癌患者行胸腹腔镜McKeown手术预后的影响
Impact of controlling nutritional status score on perioperative outcomes in esophageal cancer patients with COPD undergoing thoracoabdominal McKeown surgery
摘要
Abstract
Objective To investigate the impact of the controlling nutritional status(CONUT)score on perioper-ative outcomes in esophageal cancer patients with chronic obstructive pulmonary disease(COPD)undergoing thoracoab-dominal McKeown surgery and to explore possible underlying mechanisms.Methods A total of 134 esophageal cancer patients were included.The optimal CONUT cutoff value was determined using receiver operating characteristic(ROC)curve analysis.Patients were divided into Group A(CONUT score 4-12)and Group B(CONUT score 0-3).Perioper-ative outcomes,including postoperative pulmonary infection,respiratory failure,drainage tube retention time,antibiotic usage duration,average length of hospital stay,and perioperative neutrophil-to-lymphocyte ratio(NLR),were com-pared between groups.Multivariate stepwise regression analysis was used to identify factors affecting postoperative pulmo-nary infection.Results The incidence of postoperative pulmonary infection and respiratory failure was significantly higher in Group A than in Group B(P＜0.05).Group A also had longer durations of antibiotic usage,drainage tube retention,and hospital stay compared to Group B(P＜0.05).Perioperative NLR was significantly higher in Group A than in Group B(P＜0.01).Multivariate regression analysis showed that the CONUT score was an independent risk factor for postopera-tive pulmonary infection(P＜0.05).Conclusion The CONUT score is a significant predictor of perioperative infectious complications in esophageal cancer patients with COPD undergoing thoracoabdominal McKeown surgery.Higher CONUT scores are associated with increased risk of postoperative pulmonary infection,prolonged antibiotic therapy,longer drain-age tube retention,and extended hospital stay.关键词
食管癌/慢性阻塞性肺疾病/McKeown/控制营养状况评分/肺部感染Key words
esophageal cancer/chronic obstructive pulmonary disease/McKeown surgery/controlling nutritional status/pulmonary infection分类
医药卫生引用本文复制引用
路威,孙波,魏育涛..控制营养状态评分对COPD食管癌患者行胸腹腔镜McKeown手术预后的影响[J].广东医学,2025,46(11):1741-1746,6.基金项目
山东省医药卫生科技发展计划项目(2017WS521) （2017WS521）
济宁市重点研发计划立项项目(2024YXNS161) （2024YXNS161）
济宁市第一人民医院启航科研项目(2021-QHM-015) （2021-QHM-015）
