132例脊柱结核患者围手术期营养状况的调查分析

The perioperative nutritional status survey of 132 cases of patients with spinal tuberculosis

目的了解脊柱结核患者围手术期营养状况，为以后对围手术期患者进行针对性营养干预提供理论依据。方法调查2014年1—10月在北京胸科医院骨科住院的脊柱结核患者132例，于患者入院后24h内、术后第6天及第13天对患者进行营养风险评估[采用营养风险筛查（2002）（nutrition risk screening，NRS2002）评估表]，并于入院后次日及术后第1天、第6天及第13天早晨空腹抽静脉血查患者血红蛋白（Hb）、淋巴细胞比值（I。Y％）、淋巴细胞计数（LY）和血浆白蛋白（ALB）。用SPSS17．0软件录入数据并进行统计学分析，对不同时间点的营养风险发生率的比较采用z。检验，以P％0．05认为差异有统计学意义。用Friedman检验对不同时间点的营养评分及Hb、LY％、LY、ALB值进行K个相关样本的非参数检验，以P〈0．05认为差异有统计学意义。结果筛查脊柱结核患者围手术期营养风险的发生率，术后第6天高达87．88oA（116／132）。比较不同时间点的营养相关化验指标，术后第6天Hb[（106．27±16．74）g／L]及ALB[（31．36±3．84）g／L]测值比其他时间点都低；人院次日、术后第1天、术后第13天的Hb测值为：（130．79±16．67）g／L，（113．88±15．57）g／L，（113．38±18．08）g／L；ALB数值为：（38．74±3．90）g／L，（31．47±3．55）g／L，（34．82±3．68）g／L。术后第6天与其他时间点Hb、ALB测值比较，差异有统计学意义（7。值分别为60．151、63．951，P值均〈O．001）。术后第1天LY％为（9．83±4．84）％，LY（1．26±O．79）×10^9／L，比其他时间点都低。人院次日、术后第6天、术后第13天的LY％分别为：（23．59±8．37）％，（18．69土5．97）％，（21．50±6．78）％；LY分别为：（1．62±0．56）×10^9／L，（1．39±0．60）×10^9／L，（1．59±0．61）×10^9／L。术后第1天LY％、LY与其他时间点测值比较，差异有统计学意义（Х^2值分别为：52．370、27．662，P值均〈O．001）。结论脊柱结核围手术期患者存在较高的营养风险，患者术后1周内营养状况较差，应给予重点营养干预，以促进患者康复。

Objective To understand perioperative nutritional status in patients with spinal tuberculosis, in order to provide targeted nutritional intervention. Methods One hundred and thirty-two cases of spinal tuberculosis patients hospitalized between Jan-Oct. 2014 in Beijing Chest hospital were investigated. Patients received nutrition risk assessments （nutrition risk screening, NRS2002） within the 24 hours admitted, and 6 days, 13 days after the operation respectively. Patients also received the blood check for red protein （Hb）, and Lyre （LYV00）, count of lymphocytes （LY） and albumin （ALB） in the next day of admission, the 1st day, 6th days and 13th days after the operation. SPSS 17.0 software was used for data entry and statistical analysis, ）Х^2 test was used for comparison of the nutrition risk incidence in different points in time, P%0.05 is considered the statistically significant. Results The incidence of peri-operative nutritional risk was up to 87.88% （116/132）in the 6th postoperative day. To compare indicators of nutrition-related testing at different points, the 6th postoperative day, Hb（（106.27-t-16.74） g/L） and ALB（（31. 36 ---k- 3. 84） g/l） measuring values are lower than any other time point the Hb measurement was （130. 79±16.67） g/L, （113.88±15.57） g/L, （113.38±18. 08） g/L ALB measurement was （38. 74±3.90） g/L, （31.47±3.55） g/L and （34. 82±3.68） g/L respectively in the 1st day after hospitalization, 1st and 13th postopera- tive day. Hb and ALB measurements in the 6th postoperative day was statistically significant different in comparison with other point in time, （Z2 values is 60. 151, 63. 951 respectively, P both are %0. 001）. In 1st postoperative day,the LYG measurement was （9.83±4.84）% and LY was （1.26--0.79） X 109/L, lower than any other point in time. the LY% measurement was （23.59±8.37）% （18.69±5.97）% （21. 50±6.78）% and LY measurement was （1. 62±0. 56） ×10^9/L, （1.39-±0. 60）× 10^9/L, （1.59±0.61） ×10^9/L respectively in the next day of hospitaliza- tion, the 6th and 13th postoperative day. LY% value in the 1st postoperative day was statistically different with other time points （Z2 values are.. 52. 370, 27. 662 respectively,P both are 〈0. 001）. Conclusion The perioperative patients of spinal tuberculosis have high nutritional risk. Patients have poor nutritional status within 1 week after surgery, therefore we should focus on nutritional interventions in order to promote recovery.