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  • 李雪冬,傅传刚,杜 涛,等.术前血清前白蛋白水平与直肠癌NOSES术后住院时间的相关性[J].同济大学学报(医学版),2019,40(6):795-800,808.    [点击复制]
  • LI Xue-dong,FU Chuan-gang,DU Tao,et al.Association between serum prealbumin level and length of hospital stay after NOSES for rectal cancer[J].同济大学学报(医学版),2019,40(6):795-800,808.   [点击复制]
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术前血清前白蛋白水平与直肠癌NOSES术后住院时间的相关性
李雪冬,傅传刚,杜涛,韩俊毅,鲁兵,周主青
0
(同济大学附属东方医院胃肠肛肠外科,上海 200120; 同济大学附属东方医院普外科,上海 2000120)
摘要:
目的 探讨术前血清前白蛋白水平与直肠癌经自然腔道取标本手术(natural orifice specimen extraction surgery, NOSES)术后住院时间的相关性。方法 收集2016年1月1日至2017年6月30日在同济大学附属东方医院住院行3D腹腔镜腹部无切口直肠前切除术的73例直肠癌患者,按术前血清前白蛋白水平分为低前白蛋白组(前白蛋白<220mg/L)和正常前白蛋白组(前白蛋白≥220mg/L),分析不同前白蛋白组间患者一般资料和临床病理特征的差异,并采用Pearson相关性分析和Kaplan-Meier生存分析以及Cox比例风险回归模型进一步探讨前白蛋白与直肠癌NOSES术后住院时间的相关性。结果 低前白蛋白组和正常前白蛋白组患者间进行比较,身高、体质量、红细胞、血红蛋白、总蛋白、白蛋白、术后首次肛门排气时间、术后首次进食时间、术后住院时间、住院费用等差异均有统计学意义(P<0.05)。身高、体质量、BMI、男性、白细胞、红细胞、血红蛋白、总蛋白、白蛋白、凝血酶原时间、糖类抗原19-9、神经侵犯、术后首次肛门排气时间、术后首次进食时间、术后住院时间、住院费用与前白蛋白水平存在相关性(P<0.05),其中前白蛋白水平与术后住院时间呈负相关(r=-0.265,P=0.023),术前低前白蛋白是直肠癌NOSES术后延迟出院的独立危险因素(HR=1.861,P=0.013)。结论 术前低前白蛋白是直肠癌NOSES术后延迟出院的独立危险因素;监测术前白蛋白水平,将有助于预测直肠癌NOSES术后的近期预后。
关键词:  直肠癌  经自然腔道取标本手术  前白蛋白  术后住院时间  危险因素
DOI:10.16118/j.1008-0392.2019.06.006
投稿时间:2019-09-17
基金项目:上海市浦东新区卫生系统重点专科建设项目(PWZZK2017-26);上海市浦东新区临床高原学科建设项目(PWYgy2018-02)
Association between serum prealbumin level and length of hospital stay after NOSES for rectal cancer
LI Xue-dong,FU Chuan-gang,DU Tao,HAN Jun-,LU Bing,ZHOU Zhu-qing
(Dept. of Colorectal Surgery, East Hospital, Tongji University School of Medicine, Shanghai 200120, China; 2. Dept. of General Surgery, East Hospital, Tongji University School of Medicine, Shanghai 200120, China)
Abstract:
Objective To investigate the association between serum prealbumin levels and length of hospital stay after laparoscopic natural orifice specimen extraction surgery(NOSES) for rectal cancer. Methods From January 2016 to June 2017, 73 patients with rectal cancer undergoing 3D NOSES were enrolled in this study. Patients were divided into 2 groups according to the level of prealbumin: the low prealbumin group(prealbumin<220mg/L), and the normal prealbumin group (prealbumin≥220mg/L). The difference of the general information and clinicopathological characteristics between two groups were analyzed. The Pearson’s correlation analysis, Kaplan-Meier survival analysis and Cox proportional risk regression model were adopted to further explore the correlation between serum prealbumin level and length of hospital stay after NOSES for rectal cancer. Results There were significant differences in height, weight, erythrocyte, hemoglobin, total protein, albumin, first anal exhaust time after operation, first eating time after operation, length of hospital stay after operation and hospitalization expenses between two groups group(P<0.05). Serum prealbumin level was correlated with the height, weight, BMI, male, white blood cells, red blood cells, hemoglobin, total protein, albumin, prothrombin time, carbohydrate antigen 19-9, nerve invasion, first anal exhaust time after operation, first eating time after operation, length of hospital stay after operation and hospitalization expenses of patients (P<0.05). Among these indicators the level of prealbumin was negatively correlated with the length of hospital stay after operation(r=-0.265, P=0.023). Preoperative low prealbumin was an independent risk factor for delayed discharge after NOSES for rectal cancer(HR=1.861, P=0.013). Conclusion Preoperative low prealbumin is an independent risk factor for delayed discharge after NOSES for rectal cancer. Monitoring preoperative albumin level will help to predict the short-term prognosis of rectal cancer after NOSES.
Key words:  rectal cancer  natural orifice specimen extraction surgery  prealbumin  hospitalization time after operation  risk factor

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