STRONGkids营养风险筛查在小儿胃肠外科围手术期中的应用

The application of STRONGkids nutrition risk screening in the perioperative period of pediatric gastrointestinal surgery

目的探讨STRONGkids营养风险筛查在小儿胃肠外科围手术期中的应用,为临床进行营养支持提供依据。方法选取2016年1月至2017年10月入住我院的胃肠外科围手术期的患儿60例,年龄1个月-7岁,随机分为观察组和对照组各30例,观察组患儿采用STRONGkids营养风险筛查,对有高度营养风险者制订营养支持方案;对照组患儿则予以一般围手术期的处理。比较两组患儿术前术后前白蛋白(PA)、白蛋白(ALB)水平及患儿术后切口感染率、吻合口瘘发生率,PN相关导管感染率、住院天数。结果比较两组患儿手术前及术后1d的PA和ALB水平,差异无统计学意义(P>0.05);术后7d观察组患儿的PA及ALB水平明显高于对照组,差异有统计学意义(P<0.05);术后观察组患儿切口感染1例(3.3%),PN相关导管感染1例(3.3%),对照组切口感染3例(10.0%),PN相关导管感染2例(6.7%),观察组明显低于对照组,差异有统计学意义(P<0.05),两组患儿术后均未出现吻合口瘘;观察组患儿住院时间(10.3±0.6)d,对照组(13.4±0.5)d,差异有统计学意义(P<0.05)。结论 STRONGkids营养风险筛查工具在小儿胃肠外科围手术期中的应用,可以为临床合理运用营养支持提供借鉴与思考。

Objective To explore the application of STRONGkids nutritional risk screening in the perioperative period of pediatric gastrointestinal surgery,and to provide a basis for nutritional support in clinic. Methods Between January 2016 and October 2017 in our hospital of gastrointestinal surgery perioperative 60 cases of children,aged 1 month to 7,each 30 cases were randomly divided into observation group and control group,observation group with the STRONGkids nutritional risk screening,with highly nutritional risk shall be formulated nutritional support programs;The children in the control group were treated with general perioperative period. To compare the preoperative albumin（PA）,albumin（ALB） level and postoperative incision infection rate,anastomotic fistula incidence,PN associated catheter infection rate,and number of hospitalization days in the two groups. Results There was no statistically significant difference between the two groups（P〉0.05） before and after surgery. The level of PA and ALB of children with 7 d observation group was significantly higher than that in the control group,and the difference was statistically significant（P〈0.05）. Postoperative observation group with incision infection,1 case（3.3%）,the PN catheter related infection in 1 case（3.3%） and control infection of incision,3 cases（10.0%）,the PN catheter related infection in 2 cases（6.7%）,observation group significantly lower than the control group,difference have statistical significance（P〈0.05）,two groups of postoperative no anastomotic fistula occurred;The patients in the observation group were hospitalized（10.3±0.6）d,and the control group（13.4±0.5）d,the difference was statistically significant（P〈0.05）. Conclusion The application of STRONGkids nutrition risk screening tool in the perioperative period of pediatric gastrointestinal surgery can provide reference and reflection for the rational use of nutritional support.