医院住院患者营养风险、营养不足发生率及营养干预状况调查

Investigation on the Risk of Nutrition, the Prevalence of Undernutrition and Intervention in Hospitalized Patients

【目的】调查本院住院患者的营养风险、营养不足发生率以及营养干预的状况，以重视医院营养干预的管理和效果。【方法】利用营养风险筛查2002（NRS2002）对2008年3月至2009年3月本院内、外科系统四个专科进行调查，NRS评分／〉3分为有营养风险，体重指数（BMI）〈18．5kg／m^2（或白蛋白〈30g／L）为营养不足。并调查其营养干预情况，分析营养风险与营养干预之间的关系。【结果】654例患者中，营养不足和营养风险的发生率分别为7．0％和35．0％；四个专科中，肾内科患者的营养不足和营养风险发生率均最高，分别为19．6％和56．9％；全部患者中，营养支持率为32．3％，其中有营养风险患者（229例）的营养支持率为48．0％，无营养风险患者（425例）的营养支持率为23．8％。【结论】住院患者中营养风险或营养不足的比例较高，营养干预存在不合理性，应推广和应用基于循证医学的肠外肠内营养指南和应用规范以改善此状况。

[Objective] To investigate the risk of nutrition, the prevalence of undernutrition and nutritional intervention in hospitalized patients in our hospital and further emphasize the management of nutrition intervention and the effect in hospital. [Methods] Totally 654 adult patients in 4 departments of internal medicine and surgery were enrolled from March in 2008 to March in 2009 by fix-point consecutive sampling. Nutritional risk screening 2002 （NRS2002） was performed and nutritional intervention was evaluated in all patients. The relationship between the risk of nutrition and nutritional support was analyzed. [Results] Overall prevalence of undernutrition was 7.0% and nutritional risk was 35.0%. Among the 4 departments, both the prevalence of undernutrition and the risk of nutrition in department of nephrology were the highest which were 19.6% and 56.9%, respectively. Among all the patients, the rate of nutritional intervention was 32. 3%, which that in patients with the risk of nutrition was 48.0%（229 cases） and that in patients without the risk of nutrition was 23.8%（425 cases）. [Conclusion] A large proportion of inpatients have the risk of nutrition or undernutrition. The application of nutritional intervention is somehow inappropriate. Evidence-based guidelines are required to improve this situation.