目的 探讨肠镜干预路径下,营养状态与功能限制之间的关系,明确血红蛋白水平和蛋白质摄入对老年结直肠癌患 者功能受限风险的影响,为肠镜检查功能维护提供循证依据。 方法 基于美国国家健康与营养调查( NHANES) 数据库 2005-2018 年数据,选取 60 岁及以上的老年结直肠癌患者,评估血红蛋白水平、蛋白质摄入及功能限制状况。 采用限制性立 方样条(RCS)分析非线性关系,Logistic 回归和线性回归分析营养暴露与功能受限风险及严重程度的关联,亚组分析探讨性 别、低体质指数(BMI)、糖尿病等因素的交互作用。 结果 共纳入 319 例患者,功能限制发生率为 60. 8%。 血红蛋白水平低于 130 g / L、蛋白质摄入低于 60 g / d 时,功能限制风险显著升高(P < 0. 001)。 血红蛋白每升高 10 g / L,功能限制风险降低 34%; 蛋白质每增加 1 g,风险降低约 2%。 贫血且蛋白质不足者功能限制风险最高(OR= 19. 68,95% CI = 4. 20~ 92. 17,P < 0. 001)。 亚组分析提示男性、BMI、无糖尿病患者关联更强。 线性回归显示,血红蛋白和蛋白质摄入与功能限制得分呈负相关。 结论 肠镜干预路径下,血红蛋白和蛋白质摄入水平是老年结直肠癌患者功能限制的重要保护因素,营养状态优化是围镜期干预的 重要环节。 建议将营养风险筛查和针对性干预纳入肠镜干预路径,提升患者围手术期功能储备能力。

Objective To investigate the relationship between nutritional status and functional limitation under the endoscopic care pathway and to clarify the impact of hemoglobin levels and protein intake on functional impairment in elderly colorectal cancer patients providing evidence for peri - endoscopic functional maintenance. Method Data from the NHANES 2005 - 2018 were analyzed. Patients aged ≥60 years with colorectal cancer were included. Hemoglobin levels protein intake and functional limitation were assessed. Restricted cubic spline RCS was used to explore non -linear associations. Logistic and linear regression analyses evaluated the relationship between nutritional exposures and functional limitation risk and severity. Subgroup analyses explored the effects of gender BMI and diabetes. Result A total of 319 patients were included with a functional limitation prevalence of 60. 8%. Functional limitation risk increased significantly when hemoglobin was below 130 g / L or protein intake was below 60 g / d P < 0. 001 . Each 10 g / L increase in hemoglobin reduced functional limitation risk by 34% each 1 g increase in protein intake reduced risk by 2%. Patients with anemia and low protein intake had the highest risk OR = 19. 68 95% CI = 4. 20-92. 17 P < 0. 001 . Subgroup analyses showed stronger associations in males lower BMI and non-diabetic patients. Hemoglobin and protein intake were negatively associated with functional limitation scores. Conclusion Hemoglobin levels and protein intake are protective factors against functional limitation in elderly colorectal cancer patients undergoing endoscopic care. Optimizing nutritional status should be integrated into the endoscopic nursing pathway to enhance perioperative functional reserves.