广州住院患者营养风险筛查及营养支持状况分析

Nutritional risk screening and application of nutritional support in Guangzhou hospitalized patients

目的调查广州部分医院住院患者营养风险、营养不足发生率以及营养支持的应用状况。方法采用定点连续抽样方法,对2008年4月至2009年1月广州3所中等医院消化内科、呼吸内科、神经内科、肾内科、普外科、胸外科6个专科符合NRS2002评定标准的1682例住院患者进行营养筛查,并调查其营养支持应用情况。结果 1682例患者中,营养不足和营养风险的发生率分别为17.7%和40.0%;6个专科中,呼吸内科患者的营养不足和营养风险发生率均最高,分别为36.0%和64.0%;全部患者中,营养支持率为31.4%,其中有营养风险患者的营养支持率为47.7%,无营养风险患者的营养支持率为20.5%。结论住院患者中存在较高比例的营养风险或营养不足,肠外肠内营养临床应用存在不合理性,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。

Objective To investigate the prevalence of nutritional risk,undernutrition,and nutritional support in Guangzhou＇s hospitals.Methods Totally 1682 adult patients in 6 departments（Digestive Medicine, Respiratory Medicine,Neurology Medicine,Urology Medicine,General Surgery,and Thoracic Surgery）were enrolled from April 2008 to December 2008 by fix-point consecutive sampling.Nutritional Risk Screening 2002 （NRS2002） was performed and nutritional support was evaluated in all patients.Results Overall prevalence of undernutrition was 17.7% and nutritional risk was 40.0%.Among the 6 departments,Respiratory Medicine had the highest prevalence of both undernutrition and nutritional risk,which were 36.0% and 64.0%,respectively. Among all the patients,the rate of nutritional support was 31.4%,including 47.7%% of patients with nutritional risk and 20.5% of non-risk patients.Conclusions A large proportion of inpatients are at nutritional risk or undernutrition in Guangzhou＇s hospitals.The application of nutritional support is somehow inappropriate.Evidence-based guidelines are required to improve this situation.