住院儿童应用改良儿科营养不良风险筛查工具的临床评价

Application of modified pediatric malnutrition risk screening tool in hospitalized children

目的应用改良儿科营养不良风险筛查工具调查住院儿童营养不良风险的发生状况,评估该筛查工具的临床有效性,为临床进行营养评估和合理营养支持提供依据。方法选择2014年8月至2015年9月上海交通大学医学院附属新华医院的住院患儿为调查对象,对其进行改良的儿科营养不良风险筛查工具调查,进一步探讨营养不良风险与临床结局的关系。结果 2632例住院患儿中总营养不良风险发生率为53.2%。住院患儿年龄越小,营养不良风险发生率越高(χ~2=59.89,P<0.05);不同病种患儿营养不良风险发生率差异存在统计学意义(χ~2=425.12,P<0.05),其中消化系统(70.1%)及血液恶性肿瘤(86.7%)患儿营养不良风险发生率高于其他疾病组。在无营养支持的情况下,存在营养不良风险的患儿住院天数明显延长(Z=-9.293,P<0.05),且疾病转归差异有统计学意义(χ~2=4.937,P<0.05),住院期间并发症发生率有上升趋势,但差异无统计学意义(χ~2=2.203,P>0.05)。结论改良儿科营养不良风险筛查工具能有效地筛查出住院患儿发生营养不良的风险,有较好的临床预测性。

Objective To use the modified pediatric malnutrition risk screening tool to investigate the prevalence of malnutrition in hospitalized children and assess the clinical effectiveness of the screening tool ; to provide the basis for nutritional assessment and reasonable nutrition support. Methods Choose hospitalized children in Xinhua Hospital Affiliated to Shanghai Jiao Tong University of Medicine from August 2014 to September 2015 as the investigation subjects. The modified pediatric malnutrition risk screening tool was used to further explore the relationship between results of nutritional risk screening and the clinical outcome. Results The screening results showed that the total incidence of malnutrition in 2632 hospitalized children was 53.2%. The younger the hospitalized children were, the higher the incidence of malnutrition risk was （X2= 59.89, P 〈 0.05 ）. There was statistical difference among children with different diseases in incidence of malnutrition risk （X2= 425.12, P 〈 0.05 ）, and the incidence of malnutrition was higher in the alimentary system disease group （70.1%） and hematological malignancies group （86.7%） than in other disease groups. In the absence of nutritional support, the length of hospital stay of children with malnutrition was significantly longer （Z = -9.293, P 〈 0.05 ）, and there was a significant difference in the outcome of the disease （x^2 = 4.937, P 〈 0.05 ） ; the incidence of complications during hospitalization had a rising trend, but the difference was not statistically significant （X^2 = 2.203, P 〉 0.05）. Conclusion The results suggest that the modified pediatric malnutrition risk screening tool can effectively screen out the risk of malnutrition in hospitalized children, with better clinical predictability.