自开发营养支持软件在老年医院骨科住院患者的应用

Application of self developed nutrition support software in inpatient department of orthopedics in geriatric hospital

目的运用自开发临床营养支持软件辅助筛查老年医院骨外科成人住院患者的营养风险、营养不足的发生率并分析临床营养支持状况。方法使用自开发"个体化临床营养支持软件"营养风险筛查2002(NRS2002)和微型营养评价简法(MNA-SF)结合的方法前瞻性评定我院2016年10月至2016年12月符合入选要求的骨外科住院患者营养风险状况并进行营养治疗方案合理性点评。结果共112例纳入研究,患者平均年龄(81.4±4.7)岁,微型营养评价简法和营养风险筛查2002营养风险检出率分别为67.9%和51.8%,营养不足发生率为8.0%(BMI<18.5 kg·m-2);112例患者中,总的营养支持率为81.3%,单用肠内营养(77.4%)、肠外营养(20.4%),肠外营养作为肠内补充支持2例。肠外营养单瓶输注76.2%,"全合一"3 L袋输注23.8%;存在营养风险和无营养风险患者的营养支持率分别为82.8%和79.6%。结论目前临床经验营养支持方案不合理比例较高,营养支持软件临床应用模式开展将有利于医院个体化临床营养支持工作的全面落实和进一步规范。

Objective To screen the nutritional risk and to assess the rationality of the undergoing clinical nutrition strategies in the department of orthopaedics in geriatric hospital,with the software developed by our team. Methods With the self-development of ' individualized clinical nutrition support' software,combine the nutritional risk screening 2002( NRS2002) and short-form mini-nutritional assessment( MNA-SF) tools to prospective evaluation nutritional risk profile and rationality review of nutritional therapy of the hospital from October to December of 2016.Results Totally,112 patients were included,with a mean age of( 81.4 ± 4. 7) years. With NRS2002 and MNA-SF methods,it showed that 67. 9% and51.8% of the patients had nutrition risk,8.0% of the patients had undernutrition( BMI<18.5 kg·m-2).The overall nutrition approval rating was 81.3%,PN and EN support occupied separately 77.4% and 20.4%.There were 2 patients use both EN and PN.76.2% of patients accepted single bottle transfusion and only 23.8% used '3 in 1' mixtransfusion.Nutritional support for patients with and without nutritional risk were respectively 82.8%,79.6%.Conclusion The traditional clinical nutrition support scheme still existed irrationality.The clinical application mode of nutritional support software will be conducive to individualized hospital clinical nutrition support and further standardize work.