营养不良风险筛查表2002在肝胆外科三四级手术患者中的应用

Application of malnutrition risk screening table 2002 in patients undergoing hepatobiliary surgery at grade 3 and grade 4

目的探讨营养不良风险筛查表2002(NutritionalRiskScreening,NRS2002)用于肝胆外科三四级手术患者的应用效果。方法选取2017年1~10月肝胆外科在全身麻醉下行之四级手术的住院患者213例采用NRS2002分析患者的营养不良风险状况。根据NRS2002筛选出75例营养不良风险的患者,依据随机、双盲原则分为对照组37例和实验组38例。对照组按常规营养支持,即医生凭经验给予营养支持,实验组根据筛查结果实施营养支持。观察两组营养指标(血红蛋白、转铁蛋白、前白蛋白和淋巴细胞计数)的变化,记录两组患者的住院时间、住院费用。结果213例手术患者中有75例发生营养不良风险。不同性别患者的营养不良风险比较,差异无统计学意义(P>0.05)。年龄≥60岁和<60岁的患者营养不良风险比较,差异有统计学意义(P<0.05);进行三级手术和四级手术的患者营养不良风险比较,差异有统计学意义(P<0.05)。实验组血红蛋白、转铁蛋白、前白蛋白和淋巴细胞计数高于对照组,差异均有统计学意义(均P<0.05)。实验组住院时间和住院费用均少于对照组,差异有统计学意义(均P<0.05)。结论NRS2002是肝胆外科三四级手术患者营养不良风险筛查的有效工具,依此指导三四级手术患者进行营养支持的效果更优,且能缩短住院时间、降低住院费用。

Objective To explore the application effect of malnutrition risk screening table 2002 ( Nutritional Risk Screening, NRS 2002) in patients undergoing hepatobiliary surgery at grade 3 and grade 4. Methods From January to October 2017, 213 hospitalized patients undergoing grade 4 surgery in hepatobiliary surgery under general anesthesia were selected and NRS 2002 was used to analyze the malnutrition risk status of the patients. According to NRS 2002, 75 patients with malnutrition risk were screened out and divided into the control group (37 cases) and the experimental group (38 cases) according to the random double-blind principle. The control group received routine nutritional support, that was, doctors gave nutritional support based on experience, while the experimental group received nutritional support based on screening results. The changes of nutritional indexes ( hemoglobin, transferrin, prealbumin and lymphocyte count) in the two groups were observed, and the hospitalization time and hosp让alization expenses in the two groups were recorded. Results There were 75 cases at risk of malnutrition in 213 cases surgical patients. There was no significant difference in malnutrition risk between the two genders (P>0.05). There was a statistically significant difference in malnutrition risk between patients aged 60 years or older and those aged less than 60 years (P<0.05 ). The malnutrition risk of patients undergoing grade 3 surgery and grade 4 surgery was compared, and the difference was statistically significant (P<0.05 ). The hemoglobin, transferrin, prealbumin and lymphocyte count in the experimental group were higher than those in the control group, and the differences were statistically significant (P<0.05 ). The hospitalization time and hospitalization expenses in the experimental group were lower than those in the control group, and the differences were statistically significant (P<0.05). Conclusion NRS 2002 is an effective tool for screening malnutrition risk in patients undergoing hepatobiliary surgery at grade 3 and grade 4. Therefore, it is more effective to guide patients undergoing surgery at grade 3 and grade 4 to receive nutritional support, shorten hospitalization time and reduce hospitalization cost.