目的 分析术前控制营养状态（CONUT）评分在评估结直肠癌（CRC）患者根治性手术切除后随访预后的应用价值。 方法 回顾性总结 2014年 2月至 2016年 2月东南大学附属中大医院溧水分院确诊的 CRC患者共 186例，根据术前 CONUT评分 分为高 CONUT组（≥3分）和低 CONUT组（≤2分）。比较两组患者的临床资料和肿瘤病理学特征，Kaplan⁃Meier曲线比较 5年总 生存（OS）率，最后采用单因素和多因素Cox回归分析OS的危险因素。结果 186例患者分为高CONUT组101例和低CONUT组 85例，高CONUT组患者年龄增加、体质指数（BMI）降低、预后营养指数（PNI）降低、中性粒细胞/淋巴细胞比值（NLR）和血小板/ 淋巴细胞比值（PLR）升高、TNM分期、肿瘤直径和血清癌胚抗原（CEA）水平增加（P<0.05）。高CONUT组比低CONUT组OS率 降低，不同 TNM 分期中高 CONUT 比低 CONUT 患者 OS率降低（P<0.05）。回归分析显示，年龄≥60岁、BMI<18.5 kg/m2、TNM 分 期（Ⅱb~Ⅲ）和CONUT评分≥3是OS的独立危险因素（P<0.05）。结论 术前CONUT评分升高可能提示CRC患者手术根治性切 除后预后不良的发生风险，CONUT评分能够为临床医生制定恰当的营养干预计划提供重要参考。

Objective To analyze the application value of preoperative controlling nutritional status (CONUT) score for evaluating the follow⁃up prognosis in colorectal cancer (CRC) patients after radical resection. Methods A total of 186 patients with CRC diagnosis in Lishui Hospital from February 2014 to February 2016 were retrospectively summarized. According to the preoperative CONUT score, they were divided into high⁃CONUT group (≥ 3) and low⁃CONUT group (≤ 2). Kaplan⁃Meier curve was used to compare the 5⁃year overall survival rate (OS). Univariate and multivariate Cox regression were used to analyze the risk factors of OS. Results 186 patients were divided into high⁃CONUT group (n=101) and low⁃CONUT group (n=85). In high⁃CONUT group, the age was older, body mass index (BMI) was less, prognostic nutritional index (PNI) was lower, neutrophil/lymphocyte ratio (NLR) and platelet/lymphocyte ratio (PLR) were higher, TNM stage, tumor diameter and serum carcinoembryonic antigen (CEA) level were higher, too(P<0.05). The OS of high⁃CONUT group was lower than that of low⁃CONUT group, and the same to the patients in different TNM stages (P<0.05). Regression analysis showed that age ≥ 60 years, BMI<18.5 kg/m2, TNM stage ( Ⅱ b ~ Ⅲ) and CONUT score ≥ 3 were independent risk factors to OS (P<0.05). Conclusion Higher preoperative CONUT score may indicate the risk of poor prognosis in patients with CRC after radical resection. CONUT score can provide important reference for clinicians to formulate appropriate nutritional intervention plan.