石家庄市中小医院住院患者营养风险筛查及营养支持应用现状

Nutritional risk screening and nutritional support among inpatients in a middle hospital and a small hospital in Shijiazhuang

目的调查1所中等医院的普通外科、胸外科、消化内科、神经内科、肾内科、呼吸内科6个科室的住院患者和1所县级医院的内、外科住院患者营养风险发生率、实际应用营养支持率，为住院患者合理应用营养支持提供参考依据。方法采用营养风险筛查2002评分方法对住院患者进行营养风险筛查评估以及营养支持应用现状调查。结果中等医院6个科室住院患者的营养风险发生率为25％，其中呼吸内科营养风险发生率最高，为31％，其次为神经内科29％，以后依次为’肾内科27％、胸外科23％、消化内科22％、普通外科18％，有营养风险的患者中24％进行了营养支持，无营养风险患者中9％进行了营养支持。小医院营养风险发生率为18％，其中内科29％、外科7％，有营养风险患者使用营养支持占24％，无营养风险患者中4％进行了营养支持。结论石家庄市中小医院住院患者存在一定数量的营养风险和营养不良（不足），肠外和肠内营养存在不合理性，今后在中小医院进一步推广基于循证医学的肠外肠内营养指南和应用规范尤为重要。

Objective To investigate the hospitalized patients incidence of nutritional risk and nutritional support in six departments （general surgery, thoracic surgery, gastroenterology, neurology, urology and respirolo- gy） in a middle hospital and in the medical/surgical departments in a small hospital, so provide reference for ra- tional nutritional support for patients. Method Nutritional Risk Screening 2002 was used to assess the existence of nutritional risk and the necessity of nutritional support. Results The overall prevalence of the nutrition risk was 25% in the six departments in the middle hospital; more specifically, the prevalence of nutrition risk arranged from 18% to 31% in these six departments： 31% in the department of respiratory medicine, 29% in the department of neurology, 27% in the department of urology, 23% in the department of thoracicsurgery, 22% in the department of gastroenterology, and 18% in the department of general surgery. For those at nutritional risk, the nutritional support rate was 24%. For non-risky patients, 9% received nutritional support. The overall prevalence of nutrition risk was 18% in the small hospital; more specifically, the prevalence of nutrition risk was 29% in the department of internal medicine and 7% in the department of surgery. For those at nutritional risk, the nutritional support rate was 24%. For non-risky patients, the nutritional support rate was 4%. Conclusions Certain nutritional risk and malnutrition exist in inpatients in the middle and small hospitals in Shijiazhuang. The applications of parenteral and enteral nutri- tions still have some problems. It is of particular importance to further promote the application of evidence-based par- enteral/enteral nutrition guidelines in middle and small hospitals to standardize the application of nutritional support.