非结核分枝杆菌肺病患者营养风险筛查及营养支持状况的分析

Clinical analysis of nutritional risk screening and application of nutritional support in hospitalized patients with non-tuberculosis mycobacteria pulmonary disease

目的了解非结核分枝杆菌肺病患者营养风险、营养不足发生率,以及营养支持的应用状况,为临床实施营养干预提供参考依据。方法对2012年10月—2014年10月在广州市胸科医院就诊的非结核分枝杆菌肺病患者(符合NRS2002评定标准)的营养风险筛查与营养支持状况进行回顾性分析。结果 402例患者中,营养不足和营养风险的发生率分别为35.8%(144/402)和66.7%(268/402);所有患者中,总体营养支持率为60.0%(241/402),使用肠外营养与肠内营养的比例为3.2∶1;老年患者,女性患者,复治患者更是发生营养风险和营养不足的高危人群;存在营养风险患者的营养支持率为82.1%(220/268),不存在营养风险患者营养支持率为15.7%(21/134)。结论非结核分枝杆菌肺病患者存在较高比例的营养不足和营养风险,肠外肠内营养临床应用存在不合理性;应推广和使用NRS2002营养评定方法和肠内肠外营养指南,作为实施营养支持的依据。

Objective To investigate prevalence of nutritional risk,undernutrition,and nutritional support of hospital-ized patients with non-tuberculosis mycobacteria. Methods Adult patients in Guangzhou Chest Hospital from October 201 2 to October 201 4 were enrolled by fix-point consecutive sampling.Nutritional Risk Screening 2002 （NRS2002）was performed and nutritional support was evaluated in all patients. Results A total of 402 patients were enrolled.Overall prevalence of undernut-rition was 35.8%,and nutritional risk was 66.7%.Among all the patients,the rate of nutritional support was 60.0%,inclu-ding 82.1 %of patients with nutritional risk and 1 5.7% of non-risk patients.Gerontal patients,retreatment patients and female patients are in the greater possibility of being expose to nutritional risk or undernutrition. Conclusion A large proportion of in-patients with non-tuberculosis mycobacteria were at nutritional risk or undernutrition.The application of parenteral or enteral nutri-tional support currently maybe inappropriate.NRS2002 and parenteral or enteral nutrition guideline are required to affording nu-tritional support.