目的 调查恶性实体瘤手术患儿围手术期营养状态及其危险因素。 方法 选取海南省妇女儿童医学中心 2020 年 3 月至 2023 年 3 月收治的 60 例恶性实体瘤手术患儿,按术后 3 个月营养状况分为营养不良组和无营养不良组,分析恶性实体 瘤手术患儿围手术期营养状态及其营养不良的危险因素。 结果 术后 3 个月,60 例恶性实体瘤手术患儿中无营养不良 32 例 (53. 33%)、营养不良 28 例(46. 67%)。 营养不良组患儿体质量指数(BMI)、去脂体质指数(FFMI)、身体细胞质量指数(BCMI)低于无营养不良组,脂肪质量指数(FMI)明显高于无营养不良组(P = 0. 005、P = 0. 004、P<0. 001、P = 0. 007)。 相比无营养 不良组,营养不良组术后放化疗、入院时营养状况为中高风险占比明显更高,住院期间膳食摄入符合标准、特殊营养治疗占比 明显更低,差异有统计学意义(P<0. 001、P= 0. 001、P<0. 001、P = 0. 006)。 术后放化疗、入院时营养状况是恶性实体瘤手术患 儿营养不良的危险因素(P= 0. 017、P= 0. 029)。 结论 恶性实体瘤手术患儿围手术期营养状况差,术后营养不良风险较高,需 加强对入院时营养状况不佳及术后放化疗患儿的营养治疗。

Objective To investigate the perioperative nutritional status of children undergoing operation for malignant solid tumors and its risk factors. Method A total of 60 children who underwent operation for malignant solid tumors at Hainan Women and Children's Medical Center from March 2020 to March 2023 were enrolled. They were divided into malnutrition group and non-malnutrition group according to the nutritional status in 3 months after operation. The perioperative nutritional status of children undergoing operation for malignant solid tumors and the risk factors for malnutrition were analyzed. into malnutrition group and no malnutrition group. The perioperative nutritional status and risk factors of malnutrition in children undergoing surgery for malignant solid tumors were analyzed. Result In 3 months after operation there were 32 53. 33% children without malnutrition and 28 46. 67% children with malnutrition. BMI FFMI and BCMI in the malnutrition group were lower and FMI was significantly higher as compared with the non-malnutrition group P= 0. 005 P = 0. 004 P<0. 001 P = 0. 007 . Compared with the non-malnutrition group the proportions of children undergoing radiotherapy and chemotherapy after operation and children with medium-risk and high-risk nutritional status at admission were significantly higher. During hospitalization the dietary intake meets the standards and the proportion of special nutritional support is significantly lower in the malnutrition group P < 0. 001 P = 0. 001 P < 0. 001 P = 0. 006 . Postoperative radiotherapy and chemotherapy and nutritional status at admission were risk factors for malnutrition in children undergoing operation for malignant solid tumors P = 0. 017 P = 0. 029 . Conclusion The perioperative nutritional status of children undergoing operation for malignant solid tumors is not good and the risk of postoperative malnutrition is high. It is necessary to strengthen nutritional support for children with poor nutritional status at admission and those undergoing radiotherapy and chemotherapy after operation.