| Objective This study aims to explore the application of prognostic nutrition index(PNI)in short-term prognosis of glioma through a three-stage study.To determine the nutritional risk status of glioma patients,and to obtain simple and feasible prognostic parameters.Meanwhile,the effects of perioperative nutrition care on the short-term prognosis of glioma patients undergoing surgery were investigated.By observing the effectiveness of perioperative nutrition care under different PNI grouping states,the appropriate timing of perioperative nutrition care in glioma patients was discussed.Methods①A total of 129 glioma patients admitted to the Affiliated Hospital of Ningxia Medical University from January 2016 to December 2018 were retrospectively analyzed.The relationship between PNI and postoperative complications,total cost and postoperative hospitalization days was analyzed by collecting and combining general information,disease classification and intraoperative important events.To determine whether PNI can be an independent prognostic factor in the short term after glioma surgery.PNI=10×serum albumin value(g/dL)+0.005× peripheral blood lymphocyte count(mm3),and the truncated value will be obtained by receiver operating characteristic curve(ROC).Test was used for univariate analysis,and logistics regression analysis was used for multivariate analysis to determine the predictive value of PNI.② With historical control group as the control group,the clinical data of 31 patients with glioma who received surgical treatment and perioperative nutrition care in the Department of Neurosurgery of the Affiliated Hospital of Ningxia Medical University from January 2019 to January 2020 were collected and analyzed through single-arm clinical study.To observe the effects of perioperative nutrition care on the biochemical indexes of glioma patients at the corresponding time nodes,and to study the effects of perioperative nutrition care on the short-term clinical outcomes of glioma patients after surgery.③ Comprehensive analysis of the impact of perioperative nutrition care under different PNI groups on short-term clinical outcomes after glioma surgery,aiming to study the impact of nutrition prognosis evaluation combined with perioperative nutrition care on short-term clinical outcomes of glioma patients,and to verify the timing and necessity of perioperative nutrition care.To provide reference for better evaluation of short-term clinical outcome of glioma with nutritional prognostic indicators and the combined application of perioperative nutrition care and nutritional support in clinical nutrition.Results①The cut-off value of PNI was 51.30,and the area under the curve was 0.66(P<0.05).Under the cut-off value,PNI had predictive value on the occurrence of postoperative complications(P<0.05).However,PNI has certain limitations in the prediction of major complications.Although there are statistical differences in the prediction of intracranial infection and secondary epilepsy,it is not possible to make a good prognosis for the occurrence of pulmonary infection.② The incidence of postoperative complications in the perioperative nutrition care group was significantly lower than that in the control group.Biochemical index analysis results showed that the postoperative blood glucose of patients in the perioperative nutrition care group was more stable than that in the control group,the time of high fever caused by stress reaction was shorter,and the postoperative recovery albumin level was significantly higher than that in the control group.③ The high PNI group had a certain protective effect on glioma patients after surgery,and perioperative nutrition care was not necessary for the high PNI group patients.However,in patients with low PNI without perioperative nutrition care,the body remained in a state of inflammation for a long time after surgery,and the nutritional status was poor.The implementation of perioperative nutrition care can effectively improve the nutritional and immune status of patients in the low PNI group,and can effectively reduce the incidence of postoperative complications,and improve the short-term clinical outcome of patients with glioma.Conclusion ① PNI=51.30 can be used as an evaluation index for short-term prognosis after glioma surgery,and provide reference for clinical nutrition work.② Perioperative nutrition care has a positive effect on glioma patients under any nutritional status,and can effectively improve the occurrence of poor postoperative prognosis.③Perioperative nutrition care is not necessary for patients with high PNI,but it is recommended that patients with low PNI begin perioperative nutrition care as early as possible,even in the absence of clear nutritional problems... |
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