神经内科住院患者营养风险筛查及营养支持应用状况

Nutritional risk screening and application of nutritional support in hospitalized patients with neurological disorders

目的:评估神经内科住院患者营养不足、营养风险发生率及营养支持应用情况。方法:采用定点连续抽样,226例患者进行营养风险筛查2002(NRS2002),于患者入院次日清晨实施,NRS2002≥3分判定为有营养风险,体重指数(BMI)<18.5kg/m2并结合患者的临床情况判定为营养不足。同时调查患者住院期间的营养支持状况。结果:226例入选患者中,154例可获得BMI,其余72例不能获得BMI,以血清白蛋白(ALB)<30g/L记3分进行NRS2002评分。营养不足和营养风险的发生率分别为20.8%和31.0%。老年患者与非老年患者、农村户籍患者与城市户籍患者、超重或肥胖患者与正常BMI患者营养风险发生率各组间均无显著性差异。存在营养风险或营养不足的81例患者中,26.0%接受了营养支持;无营养风险且无营养不足的145例患者中,15.2%接受了营养支持;所有患者应用肠外营养和肠内营养的比例为1.8∶1。结论:NRS2002适用于神经内科住院患者的营养筛查。神经内科住院患者中部分存在营养风险或营养不足,营养支持应用存在一定不合理性。

Objective： To investigate the prevalence of nutritional risk, undernutrition, and application of nutritional support in hospitalized patients with neurological disorders. Methods： Two hundreds and twenty-six patients were consecutively enrolled. Nutritional Risk Screening 2002 （NRS2002） was performed on the next morning after admission and nutritional support evaluation was performed in the duration of hospital stay. Nutritional risk was defined as NRS2002 score≥3, and body mass index （BMI） 〈 18.5 kg/m2 defined as underuutrition. Results： A total of 226 patients were enrolled, and NRS2002 scoring was performed in 154 patients whose BMI data can be achieved. The prevalence of undernutrition was 20.8% and the nutritional risk was 31.0%. There was no significant difference in preva- lence of nutritional risks between the elderly patients and the younger patients, the rural patients and the urban patients, the overweight patients and the normal BMI patients. 26.0% patients with nutritional risk or undernutrition received nutrition support, and 15.2% patients without nutritional risk or undernutrition received nutrition support. The average parenteral nutrition and enteral nutrition ratio was 1.8： 1. Conclusions ： NRS2002 is a feasible nutritional risk screening tool for inpatients with neurological disorders. A large proportion of inpatients were at nutritional risk or underuutrition in department of neurology. The application of nutritional support currently is somehow inappropriate.