患者住院期间握力变化与分析

Change and Analysis of Handgrip Strength About Inpatients During Hospitalization

目的:研究患者在住院期间的握力变化及其影响因素。方法:选取926例于2012年6月1日—2012年12月31日期间在北京友谊医院住院的患者,分析其住院期间握力变化情况及其影响因素。结果:75%的患者住院期间握力降低。外科系统中,无论男性还是女性,中年组和老年组出院时的握力较入院时有所降低(P<0.05),而青年组患者则无明显差异(P>0.05)。内科系统中,所有女性患者出院握力均低于入院握力(P<0.05);男性患者中,青年组和中年组出院时的握力低于入院时握力(P<0.05),但65岁以上老年男性患者的握力在出院时虽较入院时有所降低,但差异无统计学意义(P>0.05)。Logistic回归分析结果显示,住院患者的性别、年龄及其营养风险筛查分值(NRS2002)高低影响其入院及出院握力(P<0.05),此外出院时的握力还与患者的疾病及其严重程度(所处科别、所患疾病及并发症、住院时长)有关(P<0.05)。患者营养风险筛查得分的高低主要与性别、体重指数、经口的进食途径、入院握力等因素有关(P<0.05)。结论:大部分患者住院期间握力降低,这与患者营养风险筛查得分的高低有关,而合理的营养支持途径是降低患者营养风险筛查得分的主要措施之一。

[Objective] To analyze the change of handgrip strength （HGS） in patients during hospitalization and its influencing factors.[Method] A total of 926 inpatients who were treated in Beijing Friendship Hospital from June 1th to December 31 th in 2012 were enrolled toanalyze the changes of HGS during hospitalization and its influencing factors.[Result] Totally 75％ of the inpatients＇ handgrip strength decreased.In surgical wards,whether male or female,the HGS of middle-aged and elderly groups decreased significantly at discharge （P ＜ 0.05）,while there was no significant difference in young patients （P ＞ 0.05）.In medical wards,HGS at discharge were lower than admission significantly （P ＜ 0.05）,but this couldclusion cannot be used in the male patients over 65 years old （P ＞ 0.05）.Logistic regression analysis showed that gender,age and their nutritional status impacted the HGS of hospitalized patients （P ＜0.05）,and HGS at discharge could also be influenced by the disease and its severity that the patients suffered including divisions,diseases and complications,length of hospital stay （P ＜0.05）.The score of Nutritional Risk Screening in patients was related to gender,body mass index,eating by oral approach and the HGS of admission （P ＜0.05）.[Conclusion] The HGS of most inpatients was reduced which was related to the Nutritional Risk Screening score,and reasonable nutrition support approach was one of the key measures to reduce the score of Nutritional Risk Screening.