目的 调查口腔癌患者术后营养不良现状及影响因素。 方法 采用便利抽样法选取四川大学华西口腔医院头颈肿瘤 外科在 2023 年 8 月至 2024 年 5 月住院的 420 例术前营养状况良好的口腔癌手术患者为调查对象,收集患者的一般资料,于 术后第 7 天,采用营养风险筛查 2002(NRS 2002)进行营养筛查、全球营养不良领导倡议(GLIM)标准进行营养评估,通过多因 素 Logistic 回归分析口腔癌患者术后营养不良的影响因素。 结果 口腔癌患者术后营养不良的发生率为 50. 24%。 多因素 Logistic 回归分析结果显示,男性(OR= 2. 575,95%CI = 1. 452 ~ 4. 564)、行游离组织瓣移植修复术(OR = 2. 479,95%CI = 1. 158 ~ 5. 307)、术前淋巴细胞计数(OR= 0. 223,95%CI = 0. 139 ~ 0. 359)、术前总胆固醇水平(OR = 0. 762,95%CI = 0. 596 ~ 0. 975)是口 腔癌患者术后发生营养不良的独立影响因素(P<0. 05)。 结论 口腔癌患者术后营养不良发生率高,营养支持小组应关注口腔 癌患者术后营养不良问题,重视其围手术期营养状况的动态筛查及评估,对营养不良高风险患者予以针对性营养管理,预防 及减少口腔癌患者术后营养不良的发生和发展。

Objective To determine the factors that cause postoperative malnutrition in patients with oral cancer. Method A total of 420 patients with good preoperative nutritional status who underwent oral cancer surgery in the Department of Head and Neck Oncology at West China Hospital of Stomatology Sichuan University from August 2023 to May 2024 were selected through convenience sampling and their information was collected. Nutritional assessment was performed adopting the Nutritional Risk Screening 2002 NRS 2002 and Global Leadership Initiative on Malnutrition GLIM standards on the 7th day after the operation. Logistic regression was used to analyze the factors leading to postoperative malnutrition in patients with oral cancer. Result The prevalence of postoperative malnutrition in oral cancer patients was 50. 24%. Logistic regression analysis showed that male OR = 2. 575 95%CI = 1. 452- 4. 564 free flap transplantation OR = 2. 479 95% CI = 1. 158 - 5. 307 preoperative lymphocyte count OR= 0. 223 95%CI = 0. 139-0. 359 and preoperative total cholesterol OR = 0. 762 95%CI = 0. 596-0. 975 were independent influencing factors of postoperative malnutrition in oral cancer patients P< 0. 05 . Conclusion In the face of the high incidence of postoperative malnutrition in patients with oral cancer nutrition support teams should conduct dynamic screening and assessment of perioperative nutritional status of patients with oral cancer and provide targeted nutritional management to patients with high risk of malnutrition so as to prevent and reduce the occurrence and development of postoperative malnutrition in oral cancer patients.