肌少症对胃癌患者术后早期临床预后的影响

夏德鑫; 左君波; 严玉兰; 张珍珍; 高生宝; 步雪峰

doi:10.7619/jcmp.20230242

肌少症对胃癌患者术后早期临床预后的影响

Effect of sarcopenia on early postoperative clinical prognosis of patients with gastric cancer

摘要

摘要:
目的探讨肌少症对胃癌患者的术后早期临床预后的影响。
方法选取行根治性胃切除术的胃癌患者189例为研究对象，根据2019年亚洲肌少症工作组(AWGS)推荐肌少症诊断标准分为肌少症组41例和非肌少症组148例。比较2组一般临床特征。分析肌少症对胃癌患者主要和次要临床结局的影响，以及根治性胃癌切除术后早期并发症的独立危险因素。
结果与非肌少症组相比，肌少症组患者年龄、查尔森合并症指数(CCI)、C反应蛋白(CRP)水平、美国麻醉医师协会(ASA)分级高于非肌少症组，体质量指数(BMI)以及白蛋白、血红白水平低于非肌少症组(P < 0.05或P < 0.01或P < 0.001)。肌少症组术后总早期并发症发生率高于非肌少症组，差异有统计学意义(36.6%、14.9%、P=0.002)。肌少症组术后住院时间长于非肌少症组，总住院费用高于非肌少症组，差异有统计学意义(P < 0.05或P < 0.01)。
结论肌少症是根治性胃癌切除术后早期并发症的独立危险因素。

Abstract:
Objective To investigate the effect of sarcopenia on early postoperative clinical prognosis in patients with gastric cancer.
Methods A total of 189 gastric cancer patients who underwent radical gastrectomy were selected as the study subjects. According to the diagnostic criteria for sarcopenia recommended by the Asian Working Group for Sarcopenia (AWGS) in 2019, they were divided into the sarcopenia group (41 cases) and the non-sarcopenia group (148 cases). The general clinical features of the two groups were compared. The effects of sarcopenia on primary and secondary clinical outcomes in patients with gastric cancer, and independent risk factors for early complications after radical gastrectomy were analyzed.
Results Age, Charson Comorbidities Index (CCI), C-reactive protein (CRP) level, and American Society of Anesthesiologists (ASA) grade were significantly higher in the sarcopenia group, body mass index (BMI) and albumin and hemoglobin levels were significantly lower than those in the non-sarcopenia group (P < 0.05, P < 0.01 or P < 0.001). The incidence of postoperative total early complications in the sarcopenia group was significantly higher than that in the non-sarcopenia group (36.6% versus 14.9%, P=0.002). The postoperative hospital stay in the sarcopenia group was significantly longer than that in the non-sarcopenia group, and the total hospital cost was significantly higher than that in the non-sarcopenia group (P < 0.05 or P < 0.01).
Conclusion Sarcopenia is an independent risk factor for early complications after radical gastrectomy.

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