目 录magenta
中文摘要∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙1 英文摘要∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙3 英文缩写∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙6 研究论文 不同营养风险筛查方法在妇科恶性肿瘤中的应用比较 前言∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙7 材料与方法∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙9 结果∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙10 讨论∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙17 结论∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙20 参考文献∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙20 综述 妇科恶性肿瘤营养风险筛查及营养支持的研究进展∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙24 致谢∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙36 个人简历∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙37
不同营养风险筛查方法在妇科恶性肿瘤中的应用比较
摘 要
目的：应用营养风险筛查2002 (NRS 2002)和患者主观全面评价法(PG‐SGA)，调查河北医科大学第四医院妇科恶性肿瘤患者营养风险发生率，筛选出适合妇科恶性肿瘤患者的营养风险筛查方法。
方法：选取河北医科大学第四医院妇科住院恶性肿瘤患者212例作为研究对象，分别完成NRS 2002和PG‐SGA筛查，记录术前营养筛查结果和术后并发症的发生情况及临床结局等，比较2种筛查工具在调查结果上的差异。
结果：
mount your friends1. 212 例妇科恶性肿瘤住院手术患者完成调查。其中卵巢癌、宫颈癌、子宫内膜癌分别为76、72、64例。经NRS2002和PG‐SGA筛查营养风险发生率分别为28.30%、38.21%。
2.妇科恶性肿瘤营养风险发生率与肿瘤类型、分期以及患者年龄有关，卵巢癌营养风险发生率明显高于其他两种类型肿瘤，老年患者营养风险发生率明显高于中青年患者，且分期越晚，营养风险发生率越高。
3. 212例妇科恶性肿瘤患者中84例出现了并发症情况。营养风险组患者的术后并发症发生率高于无营养风险组，且差异有统计学意义（P＜0.05）。以并发症的发生情况为“金标准”，PG‐SGA的灵敏度和约登指数高于NRS2002，特异度略低于NRS2002。绘制两种营养筛查方法预测并发症的ROC曲线，PG‐SGA的曲线下面积（AUC）0.681也高于NRS2002（0.658）。
燕麦的功效与作用
4.经Kappa检验显示，NRS2002和PG‐SGA两营养风险筛查工具具有一致性。PG‐SGA诊断阳性率（38.21%）明显高于NRS2002（28.30%），差异有统计学意义。
institute是什么意思5.存在营养风险患者的ALB、PA，均低于营养正常组患者，差异有统计学意义。且营养风险组的手术时间、术后首次排气时间、进食时间及住院时间长于营养正常组。术中出血量、住院花费多于营养正常组。hotpursuit
结论：
1.妇科恶性肿瘤营养风险发生率高，采用NRS2002和PG‐SGA筛查，营养风险的发生率分别为28.30%、38.21%。三大妇科恶性肿瘤中，卵巢癌的营养风险发生率最高（48.68%, 63.16%）。且年龄越大，分期越晚，营养风险发生率越高。
2. 有营养风险的患者术后恢复慢，住院时间延长、花费多。营养风险筛查是必要的。
food for louis3. NRS2002和PG‐SGA两种营养风险筛查工具在妇科恶性肿瘤均有较好的适用性，与NRS2002相比，PG‐SGA的检出率、灵敏度以及在预测术后并发症的价值上更好，推荐为妇科恶性肿瘤围手术期营养风险筛查工具。
关键词：营养风险筛查， 营养风险筛查工具， 妇科恶性肿瘤NRS2002， PG‐SGA
bartholin
Comparision of different nutritional risk screening methods in
gynecological malignancy
泰语你好
ABSTRACT
Objective: To investigate the incidence of nutritional risk in patients with gynecological malignant tumors in the Fourth Hospital of Hebei Medical University by applying nutritional risk screening 2002 (NRS 2002) and patient comprehensive subjective nutritional asssment (PG‐SGA), and to screen out nutritional risks suitable for patients with gynecological malignant tumor Screening tools.
Methods: A total of 212 patients with malignant tumors admitted to the gynecology department of the Fourth Hospital of Hebei Medical University were lected as the rearch objects, and the NRS 2002 and PG‐SGA screening were completed, and the results of preoperative nutrition screening and the incidence of postoperative complications and clinical outcomes were recorded , Compare the differences in survey results between the two screening tools.
Result:
1．A total of 212 inpatients with gynecological malignancy completed the survey, including 76 ovarian cancer cas, 72 cervical cancer cas, and 64 endometrial cancer cas. The incidence of nutritional risk was 28.30% and 38.21%, screened by NRS2002 and PG‐SGA respectively.
2．The incidence of nutritional risk of gynecological malignancy was related to tumor type, stage and patient age. The incidence of nutritional risk of ovarian cancer patients was significantly higher than that of other two types of tumors. The incidence of nutritional risk of elderly patients was significantly higher than that of young patients. The later the stage, the higher the incidence of nutritional risk.
bha3．84 patients had complications in 212 patients with gynecological malignancy. The incidence of postoperative complications in patients with
nutritional risk was higher than that in patients without nutritional risk, and the difference was statistically significant (P <0.05). Taking the occurrence of complications as "gold standard", the nsitivity and Jordan index of PG‐SGA were higher than NRS2002, and the specificity lower than NRS2002. The ROC curves of two nutrition screening methods were drawn to predict complications. The area under the curve (AUC) of PG‐SGA was 0.681 higher than that of NRS2002 (0.658).
4．Kappa test showed that NRS2002 and PG‐SGA had consistence in nutritional risk screening. The positive rate of PG‐SGA (38.21%) was significantly higher than that of NRS2002 (28.30%), and the difference was statistically significant.
5．ALB and PA in nutritional risk group were lower than that in normal nutrition group, and the difference significant. In addition, the operation time, first exhaust time, meal time and hospital stay of the nutritional risk group were longer than tho of the normal nutrition group. The intraoperative blood loss and hospitalization cost were more as well.
Conclusion:
1. The incidence of nutritional risk of gynecological malignancy is high. With the screening methods of NRS2002 and PG‐SGA, the incidence of nutritional risk was 28.30% and 38.21%, respectively. Among three major gynecological malignancies, ovarian cancer had the highest incidence of nutritional risk (48.68%, 63.16%). And the older the age, the later the stage, the higher the incidence of nutritional risk.
2. Patients with nutritional risk recover slowly after surgery, prolong hospital stay and spend more. Nutritional risk screening is necessary.
3. Both NRS2002 and PG‐SGA are suitable for gynecological malignant tumors. Compared with NRS2002, PG‐SGA is better on detection rate, nsitivity, and on the predicting value of postoperative complications, then is recommended as a perioperative nutrition risk screening tool for
cadeaugynecological malignancy.
