普外科老年病人手术前后营养风险筛查及临床意义

The effect of preoperative and postoperative nutritional risk screening for the elderly patients in general surgery department

目的研究普通外科老年病人手术前后营养风险筛查和病人营养状况恢复情况以及与并发症的相关性。方法对684例符合条件的普通外科老年手术病人于入院后24小时和术后进行NRS2002评分,并通过对病人手术前后血红蛋白、血清白蛋白(ALB)和前白蛋白(PA)的变化,观察病人手术前后机体营养恢复情况,记录并发症的发生率。结果术前NRS2002评分≥3分者173例(25.3%),<3分者511例(74.7%);术后NRS2002评分≥3分和<3分者分别为316例(46.2%)和368例(45.7%)。在术前NRS2002≥3分的病人术后并发症发生率为42%。在NRS2002<3分的病人术后并发症发生率22.9%。存在营养风险的患者并发症的发生率显著高于不存在营养风险的患者(P<0.05)。术后血红蛋白、血清白蛋白和前白蛋白的异常发生率显著高于术前(P<0.05)。结论普外科老年病人存在的营养风险较高,术前NRS2002≥3分的病人营养状况恢复慢,并发症的发生率升高。

Objective To investigate the correlation between the nutritional risk screening （preoperatively and postoperatively） and the nutritional recovery or complications of elderly patients in general surgery department. Methods 684 selective elderly patients were evaluated with nutritional risk screening 2002 （NRS2002） score 24 hours after admittion and after operation. The hemoglobin, serum albumin （ALB） and prealbumin （PA） were also evaluated before and afer operation, which indicate the nutrition state. The complications were also been observed. Results Before operation, 173 cases （25.3%） got NRS2002 score ≥3, 511 cases （74.7%） ＆lt;3. 316 cases （46.2%） ≥3 and 368 cases （45.7%） ＆lt;3 after operaiotn. The rate of postoperative complication in the group with NRS2002 score ≥3 was 42%, while in another group was 22.9%. The incidence of complications in patients with nutritional risk was significantly higher than that without nutritional risk （ P＆lt;0.05）. The abnormality rate of hemoglobin, serum albumin and prealbumin was remarkablely higher postoperatively than preoperatively （P＆lt;0.05）. Conclusions The elderly patients in the general surgery department have more nutritional risk. The preoperative nutritional status of patients with NRS2002 ≥ 3 have poorer recovery and higher incidence of complications.