消化内科住院患者营养风险筛查及分析

Nutritional risk screening and analysis in hospitalized patients from department of gastroenterology

目的调查并分析消化内科住院患者的营养风险发生率，及其在消化内科疾病中的分布。方法用营养风险筛查2002（NRS2002）标准，定点连续抽样，对消化内科住院患者在入院时和住院1周后分别行营养风险筛查，同时观察和分析患者的各项营养指标变化。结果营养风险筛查结果显示，383例住院患者的营养风险发生率为35．25％。≥70岁的患者发生率（53．2％）明显高于〈70岁患者（32．7％），差异有统计学意义（X2=7．558，P〈0．05）。胰腺炎患者最易发生营养风险（71．43％），其次是重症肝炎（50％）、肝恶性肿瘤（50％）及肝硬化的患者（40．45％）。383例患者中有173例进行了住院1周后的再次筛查，患者的营养风险风险发生率为24．86％，较入院时（35．83％）有所降低，差异有统计学意义（x2=4．936，P〈0．05）。患者住院期间体重、体水分率、肌肉量、骨量、血红蛋白、前白蛋白的变化均有统计学意义（t／Z值分别为2．407，-2．837，-3．432，-3．029，2．812，-2．181；P〈0．05）。结论肝胆胰内科普遍存在营养风险或不合理的营养支持，临床医生应加强对胰腺炎、重症肝炎、肝恶性肿瘤及肝硬化患者营养状况的重视，及时发现患者存在的营养风险并进行营养干预。

Objective To investigate and analyze the prevalence of nutritional risk and it＇s attribution among hospitalized patients from department of gastroenterology. Methods Continuous sampling was adopted, Nutrition Risk Screening （NRS） 2002 standard was used to assess the patients＇ nutrition status when they admission and hospitalized a week later. The changes of other nutritional indicators simultaneously was observed. Results The rate of nutritional risk in 383 hospitalized patients was 35.25%, and the incidence of patients with more than 70 years older significantly higher than that of patients with less 70 years older （53.2% vs 32.7% ,X2 = 7. 558, P 〈 0.05 ）. The most likely to have nutritional risk was pancreatitis patients （71. 43%）, then was patients with severe hepatitis （50%）, liver malignancy （50%） and cirrhosis （40.45%）. The nutritional risk of 173 patients in one week later after admission was significantly lower than that of admission （24.86% vs 35.83% ,X2 =4.936,P 〈0.05）. The change in body weight, body water rate, muscle mass, bone mass, hemoglobin and prealbumin of the patients were statistically significant （ t/Z = 2.407, -2. 837, - 3. 432, - 3. 029, - 2.812, - 2. 181 ,respectivcly;P 〈0.05）. Conclusions Clinical doctors should pay attention to the patients with pancreatitis, severe hepatitis, liver malignancy and cirrhosis about their nutritional status, so they can discover the nutritional risk of the patients promptly, and carry out the nutrition intervention appropriately.