目的 探讨围手术期预后营养指数（PNI）对结直肠癌患者3年无进展生存（PFS）期和总生存（OS）期评估的价值。 方法 选取 2012年12月至2020年1月中国人民解放军总医院海南医院经术后病理确诊的结直肠癌患者153例，根据围手术期PNI并将患者分为 不同亚组，通过Kaplan⁃Meier分析不同亚组患者预后差异，通过多因素Cox回归分析评估患者预后的影响因子。 结果 根据约登指数， 术前、术后PNI分别以48.73、45.40为界将患者分为低组和高组，两者对患者生存预测敏感度分别为71.40%、83.70%，特异度分别为59.60%、 46.20%；术前PNI低组多见于T3+T（4 P=0.02）、M1期患者（P=0.02），而术后PNI低组则多见于年龄较大患者（P=0.03），两者低组均多见于 肿瘤较大患者（均P=0.04）；术前、术后PNI低组患者PFS、OS均劣于高组（均P<0.01）；围手术期PNI是患者PFS、OS的预测因子，但相比 术前PNI，术后PNI预测较为可靠（PFS：HR=0.31，95%CI=0.14～0.69，P<0.01；OS：HR=0.26，95%CI=0.10～0.69，P=0.01）。 结论 围手术 期PNI对结直肠癌患者预后评估存在一定价值，相比术前PNI，术后PNI对患者预后评估较为可靠。

Objective To explore the prognostic value of perioperative period prognostic nutritional index (PNI) (pre⁃/post⁃PNI) in predicting the 3 years progression free survival (PFS) and overall survival (OS) in colorectal cancer patients (CRC). Method A total of 153 pathologically confirmed colorectal adenocarcinoma underwent surgery were collected from December 2012 to January 2020 in Hainan hospital of Chinese PLA general hospital, the PNI were calculated and patients were then divided into different subgroups, the survival differences of these subgroups were run by Kaplan⁃Meier analysis and the risk factors for survival were tested by COX proportional hazards model. Result According to the Youden index, taking 48.73 and 45.40 as the cut⁃off points to divide patients into low or high pre⁃PNI and post⁃PNI subgroups respectively, they have a sensitivity at 71.40%, 83.70% and a specificity at 59.60%, 46.20% individually in predicting the survival. The lower pre⁃PNI was more obvious in T3+T4 (P=0.02), M1 (P=0.02) patients; whereas the lower post⁃PNI was more apparent in older ones (P=0.03), both of which were more detectable in big tumor groups (all P=0.04). Both PFS and OS were inferior in lower pre⁃PNI and post⁃PNI ones (all P<0.01). The preoperative period PNIs were risk factor for PFS and OS; however, only the post⁃PNI was of more reliable (PFS: HR=0.31, 95%CI= 0.14-0.69, P<0.01; OS: HR=0.26, 95%CI=0.10-0.69, P=0.01). Conclusion The perioperative period PNI played an important role in predicating the survival for colorectal cancer patients. However, the post⁃PNI was more reliable when compared with the pre⁃PNI, additional studies are still needed in future.