重症监护患者营养风险筛查2002和营养支持实况调查

Application of Nutritional Risk Screening 2002 and nutrition support in critically ill patients in a Beijing- based hospital

目的调查重症监护患者营养风险筛查2002（NRS2002）和营养支持的应用现状。方法采用定点连续抽样方法，选取2011年9月至12月在北京市某三甲医院重症医学科（ICU）住院≥3d的内外科成年危重患者172例，记录患者进入ICU后的营养支持应用状况，评估患者入院24h内的营养风险状况（根据NRS2002）、营养状况（根据体重指数，BMI）和疾病严重程度（根据急性生理和慢性健康状况评分II，APACHEII）。结果营养支持率在人ICU首日最低（39．5％），至第7日达67．9％，肠外营养（PN）应用比例（33．6％-39．5％）高于肠内营养（EN）应用比例（4．1％-16．0％）。NRS2002、APACHEII评分及BMI显示160例（93．0％）患者应当接受营养支持，但仅对其中103例（64．4％）给予了营养支持，在这些患者中，92例（89．3％）的营养支持开始于入ICU3d内。结论危重患者的营养支持率不足，多数危重患者的营养支持开始得较为及时。危重患者的营养支持途径以PN为主。

Objective To investigate the application of Nutritional Risk Screening 2002 （ NRS 2002） and nutrition support in critically ill patients. Methods Totally 172 adult critically ill patients with a hospital stay e- qual to or above 3 days were consecutively enrolled from a Beijing-hospital from September 2011 to December 2011. Nutrition support was evaluated on a daily basis. NRS 2002, body mass index （BMI）, and Acute Physiology and Chronic Health Evalnation 11 （ APACHE II ） were applied to assess the nutritional risks and nutrition status within 24 hours after admission. Results Among all the patients, the rates of nutrition support were 39.5% and 67.9% on the 1st and 7th day respectively. The rate of parenteral nutrition （33.6% - 39. 5% ） was higher than that of enteral nutrition （4. 1% - 16.0% ）. NRS 2002, APACHE l] score, and BMI showed that 160 patients （93.0%） required nutrition support, but only 103 patients （64.4%） actually received nutrition support, among whom 92 （89.3 % ） were supplied with nutrition support within 3 days after admission. Conclusions The applica- tion of nutrition support in critically ill patients is insufficient in this hospital. Nutrition support is typically provided within 3 days after admission. Parenteral nutrition remains the most common type of nutrition support.