普外科住院病人营养状况及营养干预的现状调查

A survey of nutrition status and nutrition intervention for inpatients in the department of general surgery

目的:调查住院病人营养(及营养干预)状况,分析营养不良与住院时间的相关性。方法 :于2015年世界营养日纳入本院外科住院病人97例,采用世界营养日问卷进行调查。以病人BMI<18.5和(或)近3个月内非主观体重下降>5%作为营养不良的判定标准。结果:(1)所调查病人中有31例(31.96%)营养不良。(2)恶性肿瘤与非恶性肿瘤病人中营养不良患病率分别为32.50%和29.41%,两者间无统计学差异(P>0.05)。消化系统(37.88%)与非消化系统(7.14%)恶性肿瘤病人营养不良患病率间有统计学差异(P=0.03),胃、十二指肠(50.00%)与结肠直肠(16.67%)恶性肿瘤病人的营养不良患病率间亦有统计学差异(P=0.02)。(3)在营养不良和无营养不良的病人中,分别有12例(38.71%)和17例(25.76%)接受营养干预。其中,肠外营养例数是肠内营养的4倍,肠外营养主要见于消化系统疾病病人。(4)营养不良病人的住院时间显著长于无营养不良病人(P<0.001),消化系统恶性肿瘤病人的住院时间显著长于非消化系统恶性肿瘤病人(P<0.001)。结论:BMI<18.5和(或)>5%的非主观体重下降可作为初筛住院病人营养不良的标准。营养不良延长病人住院时间。住院病人营养干预及其方式,有待提高临床认知和实施。

Objectives To survey the nutrition status and nutrition intervention of the inpatients and to analyze the association of malnutrition with hospital stay. Methods A total of 97 inpatients were recruited from the department of general surgery in Ruijin Hospital with Nutrition Day questionnaires in 2015. Malnutrition was defined as body mass index（BMI） 18.5 and/or unintentional weight loss 〉5% in recent 3 months. Results Totally 31 cases（31.96%） were undernourished. There were 32.50% undernourished cases in cancer group and 29.41% undernourished cases in non-cancer group.The difference was not significant between 2 groups（P〉0.05）. The malnutrition rate（37.88%） of the cases with digestive malignant tumors was more than that（7.14%） of the cases with malignant tumors of non digestive system significantly（P=0.03）. There was also significant difference of malnutrition rate between the cases（50.00%） with gastroduodenal malignant tumors and the cases（16.67%） with colorectal malignant tumors（P=0.02）. Twelve cases（38.71%） undernourished and 17cases（25.76%） nourished received nutrition interventions. The patients received parenteral nutrition were 4 times of those received enteral nutrition. Parenteral nutrition was used most for the patients with digestive diseases. The hospital stay of the undernourished patients was significantly longer than that of the normal nourished patients（P〈0.001）. The hospital stay of the patients with digestive malignant tumors was significantly longer than that of the patients with malignant tumors of nondigestive system（P〈0.001）. Conclusions BMI 18.5 and/or unintentional weight loss 5% may act as screening variates for undernourished inpatients. Malnutrition can be an important factor to delay hospital stay. There were some unreasonable applications of nutrition interventions for inpatients. Malnutrition awareness and the practice of standard nutrition management should be improved.