某院胃肠外科住院患者营养风险筛查及营养支持状况调查

摘要

Objective To study the application status of the malnutrition, the incidence of nutritional risk, and the clinical nutrition support of inpatients preoperative in department of gastrointestinal surgery of hospital, in order to reference for reasonable implementation of clinical nutrition. Methods To screen the nutritional risk by NRS2002 score and to record the status of nutritional support before and after operation of inpatients preoperative in department of gastrointestinal surgery of hospital in 24 hours. Results Of the 277 inpatients who were targeted continuously investigated by NRS2002 in department of gastrointestinal surgery of General Hospital of Ningxia Medical University from November 2013 to February 2014, the response rate was 96.75%with 268 cases accomplished by NRS score. Of the 268 patients, there were 44 cases(16.42%) with athrepsy, 105 cases(39.18%) with nutritional risk, and 36 cases(25.71%) with nutritional risk but without nutritional support. There were 39 patients (50.65%) of 65 years and older with nutritional risk and 66 patients (34.55%) of under age of 65 with nutritional risk, the differences among different age were statically significant(x2=5.965, P=0.015). There were 66 cases(37.29%) with nutritional risk in male patients and 39 cases(42.86%) with nutritional risk in female patients, the differences among different sex were no statically significant(x2=0.782, P=0.376). Conclusion The nutritional risk and the incidence of malnutrition of inpatients in department of gastrointestinal surgery was higher, and the unreasonable nutritional support was higher(PN was obviously higher than EN). NRS2002 evaluation scale should be vigorously promoted and applied, and the renewal of knowledge skill in EN should be strengthened.%目的：研究胃肠外科新入院患者术前营养不良和营养风险发生率以及临床营养支持治疗的应用状况，为合理实施临床营养提供参考。方法采用NRS2002评分对胃肠外科新入院患者于24h内进行营养风险筛查，并记录其术前、术后营养支持状况。结果2013年11月~2014年2月，在宁夏医科大学总医院胃肠外科使用NRS2002，定点连续调查了277例新入院患者，268例完成了NRS评分，应答率为96.75%。在268例患者中存在营养不足的有44例（16.42%）；有营养风险患者105例（39.18%）；有营养风险但无营养支持的患者有36例（25.71%）；年龄≥65岁患者中有营养风险39例（50.65%），年龄＜65岁患者有营养风险66例（34.55%），不同年龄之间差异有统计学意义（x2=5.965，P=0.015）；男性中有营养风险的有66例（37.29%），女性中有39例（42.86%），不同性别之间差异无统计学意义（x2=0.782，P=0.376）。结论该院胃肠外科住院患者的营养风险和营养不良发生率高，并且在该科住院患者中存在不合理营养支持现象（PN明显大于EN）。在以后的工作中，我们应该大力推广NRS2002评估表的应用，加强EN知识技能的更新。