目的 调查老年住院患者的营养风险、营养不足发生率以及营养支持状况,为指导老年住院患者营养治疗提供依据.方法 采用定点连续抽样的方法,用营养风险筛查表(NRS2002)对426例老年住院患者进行营养风险筛查,NRS2002总分≥3分为有营养风险；体重指数(BMI) ＜18.5 kg/m2(或血清白蛋白＜ 30 g/L)为营养不足.调查营养干预情况,分析营养风险与营养干预之间的关系.结果 426例老年住院患者中,营养不足和营养风险的发生率分别为30.5％和55.2％,其中老年期痴呆患者(80.6％,)、恶性肿瘤(79.1％)、肺部感染或COPD(71.2％)和危重症患者(心力衰竭、呼吸衰竭或肾功能不全75％)营养风险的发生率较高.426例患者中,199例(46.7％)接受了营养支持,其中有营养不足和营养风险患者的营养支持率为75.8％ (178/235),无营养风险患者的营养支持率为19.9％(38/191).结论 老年住院患者营养不足、营养风险发生率较高,尤其以老年期痴呆患者更为突出,但临床营养支持却存在不合理性.因此,对老年住院患者的临床营养支持的规范性值得进一步探讨.%Objective To investigate nutritional risks,under-nutrition rates and nutritional interventions among elderly inpatients in order to provide evidences of nutritional support.Methods The international standard of Nutritional Risk Screening (NRS,2002) was applied to assessment the nutritional risks of 426 elderly inpatients with fix-point consecutive sampling.The total score of NRS ≥3 indicated the nutritional risk,body mass index (BMI) ＜ 18.5 kg/m2 or serum albumin ＜ 30 g/L indicated undernutrition.The nutritional interventions,the relationship between nutritional risks and nutritional support was analyzed.Results The respectively rate of undernutrition and nutritional risk was 30.5％ and 55.2％ among 426 elderly inpatients.The rate of nutritional risks in proper ordered for patients with diagnosis of dementia (80.6％,25/31),diagnosis of cancer (79.1％,34/43),diagnosis of pulmonary infection or COPD (71.2％,52/73),diagnosis of heart failure,respiratory failure,or kidney dysfunction (75 ％,15/20).199 cases (46.7％,199/426) was received nutritional interventions in which the nutritional support rate was 75.8％ (178/235) for patients with nutritional risks and 19.9％ (38/191) for those without nutritional risks.Conclusions The nutritional risks and under-nutrition are common in the elderly inpatients,especially for the dementia patients.However,the application for nutritional intervention is not reasonable.Therefore,it is necessary to have further discussion of nutritional support standardization for elderly inpatients.
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