[Prognostic nutritional index in gastrointestinal surgery of malnourished cancer patients].
[Prognostic nutritional index in gastrointestinal surgery of malnourished cancer patients].
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发表时间：
1984-09
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通讯作者：
T. Onodera;N. Goseki;G. Kōsaki
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作者：
T. Onodera;N. Goseki;G. Kōsaki
在对200例消化器官营养不良的癌症患者进行评估的基础上，定义了一个多参数的营养状况指数，将术后并发症的风险与基线营养状况联系起来。预后营养指数(PNI)=10Alb建立了手术并发症、死亡率或两者与营养状况相关的线性预测模型。+0.005淋巴。C.，在那里Alb.是血清白蛋白水平(g/100毫升)和淋巴。C.外周血中淋巴细胞总数/mm~3。当前瞻性地应用于189例胃肠外科手术患者时，这些患者营养不良且术前接受TPN治疗，该指标提供了手术风险的准确、定量的估计。一般情况下，胃肠道切除吻合术在胃肠道指数大于45时是安全的。同样的程序在45岁到40岁之间可能是危险的。在40岁以下，这种手术可能是禁忌。预后营养指数也有助于了解晚期癌症患者的预后。尽管对接近晚期的癌症患者实施TPN，但如果PNI保持在40以下，淋巴细胞总数保持在1000个/mm3以下，患者在接下来的两个月内死亡的可能性很高。
Based on assessment of 200 malnourished cancer patients of digestive organs, a multiparameter index of nutritional status was defined to relating the risk of postoperative complications to base line nutritional status. The linear predictive model relating the risk of operative complication, mortality or both to nutritional status is given by the relation: prognostic nutritional index (PNI) = 10 Alb. + 0.005 Lymph. C., where Alb. is serum albumin level (g/100 ml) and Lymph. C. is total lymphocytes count/mm3 peripheral blood. When applied prospectively to 189 gastrointestinal surgical patients those who were malnourished and treated by TPN preoperatively, this index provided an accurate, quantitative estimate of operative risk. In general, resection and anastomosis of gastrointestinal tract can be safely practiced when the index is over 45. The same procedure may be dangerous between 45 and 40. In below 40, this kind of operation may be contraindicated. The prognostic nutritional index is useful also to know the prognosis of patients with terminal cancer. Despite practicing TPN to cancer patients with near terminal stages, if the PNI remains below 40 and total lymphocytes count remains below 1,000/mm3, the patients has high possibility to die within the next two months.