吸烟饮酒对胃癌治疗前血红蛋白、PLR、NLR的影响及护理对策

目的 探讨吸烟饮酒对胃癌治疗前血红蛋白、血小板淋巴细胞比率（platelet to lymphocyte ratio,PLR）、中性粒细胞淋巴细胞比率（neutrophil to lymphocyte ratio,NLR）的影响.方法 纳入202例胃癌病例,单因素Kruskal-Wallis和多元线性回归分析吸烟、饮酒与胃癌治疗前血红蛋白、PLR、NLR的关系.结果 Kruskal-Wallis显示吸烟对胃癌治疗前血红蛋白、PLR、NLR差异有统计学意义（P=0.010,0.009,0026）,饮酒则对胃癌治疗前血红蛋白、PLR、NLR无明显影响（P=0.415,0.090,0.168）.多元线性回归显示吸烟对胃癌治疗前血红蛋白（P=0.001）、PLR（P=0.001）有显著关联,但对胃癌治疗前NLR无显著关联（P=0.246）;饮酒对治疗前血红蛋白（P=0.930）、PLR（P=0.665）、NLR （P=0.817）无显著关联;吸烟（P=0.988）、饮酒（P=0.407）不是影响胃癌分期的独立影响因素.结论 吸烟是影响胃癌治疗前血红蛋白降低、PLR升高的独立危险因素,应加强护理干预,改善患者血红蛋白及全身性炎症反应.

The impact of smoking and drinking on hemoglobin,platelet to lymphocyte ratio,neutrophil to lymphocyte ratio in patients with gastric cancer before treatment and its nursing strategy

Objective To investigate the impact of smoking and drinking on hemoglobin,PLR （platelet to lymphocyte ratio）,NLR （neutrophil to lymphocyte ratio） in patients with gastric cancer before treatment.Method The relationship between smoking,drinking and hemoglobin,PLR,NLR in 202 patients with gastric cancer before treatment was analyzed by single factor Kruskal-Wallis and multivariate linear regression analysis.Results Kruskal-Wallis showed smoking had a significant effect on pretreatment hemoglobin,PLR,NLR （P=0.010,0.009,0.026）,while drinking had no significant effect on pretreatment hemoglobin,PLR,NLR （P=0.415,0.090,0.168）.Multivariate linear regression analysis showed there were significant correlations between smoking and pretreatment hemoglobin,PLR （P=0.001,0.001）,while no significant correlation between smoking and NLR （P=0.246）; there were no significant correlations between drinking and pretreatment hemoglobin,PLR,NLR （P=0.930,0.665,0.817）.Smoking and drinking were not independent risk factors for the stage of gastric cancer （P=0.988,0.407）.Conclusions Smoking is a independent risk factor for pretreatment hemoglobin decreasing and pretreatment PLR increasing in patients with gastric cancer.Nursing intervention should be reinforced to improve hemoglobin and systemic inflammatory response in patients with gastric cancer.