骨科住院患者营养风险及营养不足的现况调查

摘要

目的 了解骨科住院患者营养风险、营养不足的现况,为规范骨科住院患者营养支持提供客观依据.方法 采用方便抽样法,连续选取2013年11月—2015年12月宁波市第一医院骨科住院患者为调查对象,收集患者一般资料录入电子数据收集系统(EDC),采用营养风险筛查2002(NRS2002)评估患者营养风险,应用指南推荐标准调查患者的营养不足现状.结果 3083例骨科住院患者中,存在营养风险的患者451例,营养风险发生率为14.63%,其中营养不足的患者59例.骨科营养风险发生率居前3位的依次为髋部骨折、骨盆骨折、胸腰椎骨折,其营养风险发生率分别为56.55%、51.61%、27.93%.不同年龄的骨科患者,其营养风险、营养不足发生率差异均有统计学意义(P<0.05).年龄≥70岁的髋部骨折患者、胸椎骨折患者营养风险发生率高,分别为79.10%(140/177)、74.19%(92/124),均高于<70岁的髋部骨折患者、胸椎骨折患者,差异有统计学意义(P<0.05).结论 骨科住院患者中髋部骨折、骨盆骨折、胸腰椎骨折患者及高龄老年患者营养风险发生率高,骨科患者规范营养支持有待进一步提高.%Objective To investigate the status quo of nutritional risks and malnutrition of orthopedic inpatients and to provide an objective basis for standardizing nutritional support for orthopedic inpatients. Methods Patients who were hospitalized in the Department of Orthopedics, Ningbo First Hospital between November 2013 and December 2015 were continuously selected as respondents by convenience sampling. Their general data were recorded in an electronic data collection system (EDC). Then the patients were assessed for nutritional risks with nutritional risk screening 2002 (NRS 2002), and their status quo of malnutrition was identified according to recommendatory standards of guidelines.Results Totally 451 out of the 3083 patients suffered from nutritional risks, and the incidence of nutritional risks was 14.63%. 59 of them were diagnosed with malnutrition. Patients with hip fracture showed the highest incidence of malnutrition, followed by those with pelvic fracture and thoracolumbar fracture, and their incidences of nutritional risks were 56.55%, 51.61% and 27.93%, respectively. There were statistically significant differences between patients of different ages (P<0.05). The incidences of hip fracture and thoracolumbar fracture patients aged above 70 were 79.10% (140/177) and 74.19% (92/124), respectively, higher than those of patients under 70 years old (P<0.05). Conclusions Orthopedic inpatients and elderly patients, especially those with hip fracture, pelvic fracture and thoracolumbar fracture, show high incidence of nutritional risks. Therefore, the nutritional support for orthopedic inpatients should be further standardized.