Correlation Analysis Of Preoperative Nutritional Risk And Perioperative Status And Prognosis In Patients With Stage BCLC-B Hepatocellular Carcinoma

Objective: To investigate the relationship between preoperative nutritional risk and prognosis of patients with BCLC-B hepatocellular carcinoma(HCC).For the nutritional risk of patients in the perioperative period can take appropriate effective diagnosis and treatment measures to provide a reference.Methods: The clinical data of 243 cases of BCLC-B hepatocellular carcinoma were retrospectively analyzed.These patients were screened for nutritional risk using the nutritional risk index,which was divided into nutrition risk group and non-nutrition risk group.The t-test and chi-square test were used to analyze the clinical indexes of preoperative,intraoperative and postoperative.The changes of clinical indexes between preoperative and postoperative patients were compared by rank sum test.Kaplan-Meier method was used to analyze the recurrence rate and survival rate of the two groups after 1,3 and 5 years.Results: 1.There were 75 cases(30.9%)and 168 cases(69.1%)in our research.The preoperative serum albumin was lower in the nutritional risk group than in the non-nutritional risk group,and the difference was statistically significant.The pre albumin was lower than that in the non-nutritional risk group(P = 68.15),and the difference was statistically significant(P=0.000).In the nutritional risk group,the preoperative transferrin was lower than that of the non-nutritional risk group,and the difference was statistically significant(?2=2.429,P=0.000).The prothrombin time was longer than that in the non-nutritional risk group,and the difference was statistically significant(P=0.030).2.There was no significant difference between the two groups in the extent of hepatic resection,hepatic portal occlusion time and operation time.The amount of bleeding in the nutritional risk group was significantly higher than that in the non-nutritional risk group,and the difference was statistically significant(P=0.041).3.There are patients with nutritional risk group the serum albumin and prealbumin than those without nutritional risk group(P < 0.05),and patients with nutritional risk group compared to serum albumin,prealbumin and preoperative degree of change,the degree of change was less than without nutritional risk group(P < 0.05);nutritional risk group the total complication rate(38.6%,65/168)than those without nutritional risk group(53.3%,40/75),the difference was statistically significant(?2=4.776 P =0.029);nutritional risk group(49.3%)postoperative pleural effusion was higher than that of non-nutritional risk group(35.1%),the difference was statistically significant(?2=9.287 P=0.002);nutrition the risk group(17.3%)postoperative abdominal bleeding ratio than those without nutritional risk group(8.3%),the difference was statistically significant(?2=4.442 P=0.039);nutritional risk group(20%)after operation The severity of liver dysfunction was higher than that of the non-nutritional risk group(10.1%),and the difference was statistically significant(?2=6.778 P=0.009).4.Nutritional risk group 1,3,5 year recurrence rate were 52.2%,82.4%,93%,no nutritional risk group were 1,3 and 5 year recurrence rate were 31.3%,59.1%,83%,nutritional risk group after 3 and 5 years recurrence rate than those without nutritional risk group,the difference was statistically significant(P<0.05).Nutritional risk group 1,3,5 year survival rate after operation was 77.5%,55.1%,50.3%,1 and 3 without nutritional risk group,5 years survival rate after operation was 88.3%,74.7%,70.6%,nutritional risk group after 3 and 5 years survival rate was lower than that of no nutritional risk group was statistically significant the difference(P<0.05).Conclusion: Preoperative serum albumin,lower prealbumin,less clotting function,more intraoperative blood loss and more postoperative complications in patients with nutritional risk before surgery compared with those without nutritional risk,Postoperative recurrence rate and survival rate is lower;BCLC-B patients with HCC after admission should be nutrition risk screening,and found that patients with nutritional risk,so that in the course of treatment of these patients to take appropriate effective measures to reduce Complications occur and get better.