基层综合性医院住院患者临床营养支持状况分析

Clinical nutritional support of inpatients in primary comprehensive hospitals

目的:调查基层综合医院住院患者入院和入院2周(或出院)时营养风险、营养不足、超重、肥胖和营养支持的状况。方法:采用定点连续抽样,选择2008年10月至2009年10月在衢州市人民医院住院的年轻患者进行营养风险筛查,使用营养风险筛查2002(NRS2002)于患者入院和入院2周(或出院)时实施,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/m2并结合患者临床情况判定为营养不足。结果:1 618例入选者完成筛查。入院时总营养风险发生率为35.0%,营养不足、超重和肥胖的发生率分别为8.0%、33.3%和17.9%。存在营养风险和无营养风险患者的营养支持率分别为20.1%和9.0%。结论:目前基层综合医院患者营养风险评估和营养支持应用尚不规范,应推广和使用NRS2002营养评定方法和肠外肠内营养指南以改善此状况。

0bjectiveTo determine nutritional risk,undernutrition,overweight,and obesity as well as nutritional support and the changes of nutritional risks from admission to discharge or over a two-week period.Methods A consecutive sampling was performed.Data were collected from 6 departments of Quzhou hospital from October of 2007 to October of 2008.Patients were screened by using Nutritional Risk Screening 2002(NBS2002)on admission and two weeks after admission(or discharge).The nutritional support application during hospital stay was recorded.NRS2002 score≥3 was classified as nutritional risk.BMI<18.5 kg/m2 with impaired general condition was defined as undernutrition.Results Among 1,618 enrolled patients,the nutritional risk,undernutrition,overweight,and obesity accounted for 35.0%,8.0%,33.3%,and 17.9%,respectively at admission.20.1% of patients who were at nutritional risk received nutritional support while 9.0% non-risk patients received nutritional support.Conclusions NRS2002 is a feasible nutritional risk screening tool for inpatients.The application of nutritional support currently is somehow inappropriate.Evidence-based guidelines are required to improve this situation.