住院病人营养不良风险的调查

A NUTRITIONAL RISK SCREENING OF HOSPITALIZED PATIENTS

目的调查我院5个科室住院病人营养不良发生率、营养不良风险发生率和实际应用营养支持率。方法选择我院消化内科、呼吸内科、神经内科、普通外科和胸外科新住院病人1000例。病人入院后首先评估是否符合营养不良风险调查(NRS)评定条件,符合者第2天早晨进行评定;对不符合条件病人检测血清清蛋白(sALB),按中国人正常值sALB<35g/L判定为营养不良。体质指数(BMI)采用中国标准<18.5kg/m2判定为营养不良。采用NRS2002方法判定是否需要营养支持。结果1000例新住院病人NRS的完全适用率为82.6%(826例),部分适用率为17.4%(174例);营养不良的发生率为6.7%(55例);需要营养支持率为23.2%;应用肠外、肠内营养支持率:1～3d者7.6%(76例),4～5d者8.5%(85例),5d以上者13.5%(135例)。以上指标消化内科、呼吸内科、神经内科、普通外科、胸外科5个科室明显不同。结论结合中国人正常值,应用NRS来评定营养不良以及判断是否需要营养支持是可行的,本文资料对于合理应用肠外、肠内营养有意义。

Objective To survey the incidence of malnutrition, of malnutrition risk, and of nutritional support in hospitalized patients. Methods This study included 1 000 patients newly admitted to departments of gastroenterology, respiratory, neurology, general surgery, and thoracic surgery. On admission, the patients were assessed if they met the requirements of nutritional risk screening （NRS）. For those fitted, the evaluation was done the next morning; for those unfitted, the serum albumin （sALB）, body mass index （BMI） were detected, sALB〈35 g/L, or BMI〈18.5 kg/m^2 was regarded malnutrition, according to Chinese standard. NRS 2002 was used to estimate if nutritional support was needed. Results There were 826 patients adaptable to be evaluated with NRS, and 174 unadaptable. Malnutrition was noted in 6.7% （55 patients）; 23.2% were regarded at risk of malnutrition. Of whom, 76 patients received nutritional support for 1 to 3 days, 85 for 4 to 5 days, and 135 for more than 5 days. There were significant differences in terms of the above parameters among five departments studied. Conclusion Combining with the Chinese standard on nutrition, to assess whether the patients suffer from malnutrition or need nutritional support using NRS 2002 method is feasible. The information of this study is helpful in doing parenteral alimentation or enteral nutrition.