呼吸内科住院患者营养风险筛查

Nutritional risk screening in hospitalized patients with respiratory disorders

目的调查呼吸内科住院患者的营养风险、营养不足发生率及营养支持应用状况。方法以2008年10月至12月在北京积水潭医院呼吸内科住院的100例患者为研究对象，入院后第2天和住院2周或出院时进行营养风险筛查2002（NRS2002）。营养不足判定标准为体重指数〈18．5kg／m2、血清白蛋白〈35g／或前白蛋白〈20g／L。结果住院2周或出院时NRS2002筛查结果显示，所有患者营养风险及营养不足发生率分别为59％及54％；卧床患者的营养风险和营养不足发生率分别为87．8％和82．9％，明显高于非卧床患者的32．2％和30．5％（P〈0．001）；住院时间大于2周患者的营养风险和营养不足发生率分别为75．0％和66．2％，明显高于小于2周患者的9．4％和21．9％（P〈0．001）。所有患者的营养支持率为22％，其中肠外营养与肠内营养的比例为1．2：1。结论NRS2002适用于呼吸内科住院患者的营养风险筛查。卧床和住院时间大于2周可能增加呼吸内科住院患者营养风险和营养不足的发生率。营养支持的应用在呼吸内科患者中仍不够充分和合理。

Objective To explore the nutrition risk, undemutrition rates, and nutrition support in the hos- pitalized patients with respiratory disorders. Methods Totally 100 hospitalized patients in department of respirato- ry medicine of our hospital from October to December 2008 were enrolled in this study. The nutrition risks were screened on the next day after admission and then two weeks later using Nutrition Risk Screening （ NRS2002 ）. Body mass index （BMI） lower than 18.5 kg/mz, serum albumin （sALB） lower than 35 g/L, or pre-ALB was lower than 20 g/L was regarded as undemutrition. Results Among all these 100 patients evaluated by NRS2002, 59 patients were judged at the risk of malnutrition and 54 patients developed undemutrition two weeks later. The nutrition risk and undemutuition rate among non-ambulatory patients were 87.7% and 82. 9% , which were signifi- cantly higher than in ambulatory patients （32.2% and 30. 5% ） （P 〈0. 001 ）. The nutrition risk and underuutu- ition rate were also significantly higher in patients who stayed in the hospital for more than 2 weeks than those for less than 2 weeks （75.0% vs 9.4% and 66.2% vs 21.9%, respectively） （ P 〈 0. 001 ）. Twenty-two patients received nutritional support. The ratio of parenteral nutrition and enteral nutrition was 1.2 ： 1. Conclusions NRS2002 can be used in the nutrition assessment in hospitalized patients with respiratory disorders. Non-ambulato- ry and a hospital stay of more than 2 weeks increase the nutritional risk and undernutrition rate. Only a small per- eentage of patients receive nutritional support.