云南省儿科住院患儿营养风险筛查与营养状况调查

Research of Nutrition Risk Screening and Nutrition Status of Pediatric Hospitalized Children in Yunnan Province

目的对儿科住院患儿进行营养风险筛查及调查营养不良发生率,为进行临床营养支持提供依据,为建立营养风险筛查制度提供数据支持.方法采用STAMP营养风险筛查工具对2015年9月入住昆明医科大学附属儿童医院的754例患儿进行营养风险筛查,并通过体格测量进行营养评估,对存在高营养风险的患儿进行再次评估.结果 754例住院患儿中15.9%的患儿(120例)存在高度营养风险,57.6%的患儿(434例)存在中度营养风险.营养不良检出率为13.4%(101例),其中重度营养不良检出率1.9%(14例),轻中度营养不良检出率11.5%(87例).高营养风险患儿营养不良检出率(34.2%)高于中度营养风险患儿营养不良检出率(13.8%).血液肿瘤、腹部手术、慢性肝病、慢性肾病、先天性心脏病等疾病较其他疾病营养风险高、营养不良检出率高(P<0.05).少数民族患儿高度营养风险检出率、营养不良检出率高于汉民族(P<0.05).存在营养风险的患儿再次筛查后营养风险评分增加率为25.8%,腹部手术疾病增加最为明显.结论儿科住院患儿存在较高营养风险及营养不良发生率.STAMP评分法评估住院患儿营养风险,能早期发现住院患儿营养不良以及可能恶化的患儿,利于全面营养评估与及时合理的营养支持,改善营养结局.

Objectives Screening the nutrition risk and investigating the incidence of malnutrition of pedi- atric inpatients in order to provide evidence for further clinical nutrition support and data support for building the sys- tem of nutritional risk screening. Methods Evaluate the nutrition risk of 754 cases of hospitalized children in September 2015 with nutritional risk screening tool, the STAMP scale, assess their nutrition status with physical measurement, and reassess those who are in high risk. Results In 754 cases of hospitalized children15.9% of them （120 cases） have high nutritional risk and about 57.6% of them （434 cases） have medium nutritional risk. Malnu- trition detection rate is 13.4% （ 101 cases） , 1.9% （ 14 cases） of which suffer from severe malnutrition, and 11.5% （87cases） suffer from mild-to-moderate malnutrition. 34.2% of children with high nutrition risk are detected with malnutrition, which is higher than those with moderate nutrition risk （13.4%） . Blood tumor, abdominal surgery, chronic liver disease, chronic kidney disease, congenital heart disease are linked with high nutritional risk and high malnutrition rate.The minority have higher nutritional risk and higher malnutrition rate than the Han nation- ality.After re-screening the children with high nutrition risk, their nutrition risk is found to have increased 25.8%, most of whom are the patients with celiac disease. Conclusions Pediatric hospitalized children exist high nutritional risk and high incidence of malnutrition. Using the STAMP scale to evaluate nutritional risk helps to detect malnutri-tion or potential nutritional risk at an early stage, thus is conducive for comprehensive nutrition assessment, rea- sonable nutrition support in time and the nutrition outcome improvement.