北京大医院神经科住院患者营养风险、营养不足、超重和肥胖发生率及营养支持应用状况

Prevalence of nutritional risk, undernutrition, overweight/obesity, and application of nutrition support in departments of neurology in metropolitan hospitals in Beijing

目的调查北京大医院神经科住院患者营养风险、营养不足、超重和肥胖发生率及营养支持应用情况。方法对2005年3月至2006年3月在北京3家大医院神经科住院的患者进行营养风险筛查2002（NRS2002），于患者人院次日早晨实施，并调查患者2周内（或至出院时）的营养支持状况，分析营养风险和营养支持之间的关系。NRS2002≥3分为有营养风险，体重指数（BMI）〈18．5kg／m。（或白蛋白〈30g／L）结合临床情况判定为营养不足。结果共有753例住院患者入选，其中461例（61．2％）完成NRS2002筛查。营养不足和营养风险的发生率分别为4．2％和21．2％，如果将不能获得BMI值的患者排除，则两者的发生率分别为5．4％和10．8％。在160例有营养风险的患者中，有23例（14．4％）接受了营养支持；在593例无营养风险的患者中，有13例（2．2％）接受了营养支持。所有患者肠外和肠内营养的应用比例为1：2。结论北京大医院神经科中有相当量的住院患者存在营养风险或营养不足，营养支持应用存在某些不合理性，应推广和应用基于证据的肠外肠内营养指南以改善此状况。

[ Abstract] Objective To investigate the prevalence of nutritional risk, undernutrition, overweight/obesi- ty, and application of nutrition support in departments of neurology in 3 metropolitan hospitals in Beijing. Methods Adult patients in the departments of neurology from 3 metropolitan hospitals in Beijing were consecutively en- rolled from March 2005 to March 2006. Nutritional Risk Screening 2002 （NRS2002） score ≥3 was defined as nu- trition risk, while body mass index （BMI） 〈 18.5 kg/m2 as undemutrition. NRS2002 was performed on the next morning of admission and nutritional support evaluation was performed on the 14th day of admission or discharge day. The relationship between nutrition risk and nutrition support was analyzed. Results A total of 753 patients were enroUed. NRS2002 scoring results were obtained in461 patients. The prevalence of undernutrition was4. 2% and nutritional risk was 21.2%. Among them 292 cases in undernutrition category were estimated by serum albu- min 〈 30g/L without accurate BMI. If the cases without accurate BMI were excluded, the prevalence of undemutri- tion was 5.4% and nutritional risk was 10. 8%. Twenty-three patients （ 14.4% ） with NRS2002 1〉 3 received nutrition support. Thirteen patients （2. 2% ） with NRS2002 〈 3 received nutrition support. The average PN： EN ratio was 1 ： 2. Condusions A large proportion of inpatients were at nutritional risk or undernutrition in the de- partments of neurology in metropolitan hospitals in Beijing. The application of nutrition support was somehow inap- propriate in these patients. Evidence-based guidelines are required to improve this situation.