营养风险筛查在冠状动脉旁路移植术患者中的应用

Nutritional risk screening in patients undergoing coronary artery bypass grafting

目的调查冠状动脉旁路移植术(CABG)患者存在营养风险基本情况以及早期营养支持对存在营养风险患者预后的影响。方法选取2014年6月至2018年6月实施CABG患者1 286例,按照NRS2002进行营养风险筛查,将存在营养风险的患者随机分为对照组和试验组,给予营养支持,对两组患者术后总蛋白(TP)、清蛋白(ALB)、前清蛋白(PAB)、转铁蛋白(TRF)、并发症、术后住院时间等方面进行对比分析。结果存在营养风险患者(NRS≥3分)714例(55.5%),其中营养不良患者占22例(1.7%),分为对照组357例,试验组357例。试验组PAB、TRF在术后第5、7天高于对照组,差异有统计学意义(P<0.05,P<0.01),TP、ALB在术后第7天高于对照组,差异有统计学意义(P<0.05)。试验组术后并发症少于对照组,术后住院时间短于对照组,差异均有统计学意义(P<0.05)。结论 CABG术患者存在营养风险比例较高,术后早期对存在营养风险的患者给予营养支持可以改善患者的各项营养指标,减少并发症和缩短术后住院时间。

Objective To investigate the nutritional risk of patients with coronary artery bypass grafting(CABG) and the effect of early nutritional support on the prognosis of patients with nutritional risk.Methods A total of 1 286 patients with CABG who received treatment from June 2014 to June 2018 were selected and received nutritional risk screening according to NRS2002.The patients with nutritional risk were randomly divided into control group(without nutritional support) and experiment group(with nutritional support).The total protein(TP),albumin(ALB),prealbumin(PAB),transferrin(TRF),complications and hospital stay were compared between the two groups.Results There were 714(55.5%) patients with nutritional risk(NRS ≥ 3),among which 22(1.7%) were malnutrition,and patients were divided into control group(357 cases) and experimental group(357 cases).The PAB and TRF in the experimental group were significantly higher than those in the control group on the 5 th and 7 th day after operation(P<0.05).TP and ALB were significantly higher than those in the control group on the 7 th day after operation(P<0.05).The postoperative complications in the experimental group were less than those in the control group,and the postoperative hospital stay was shorter than that in the control group(all P<0.05).Conclusion The proportion of patients with nutritional risk in CABG is high.Early postoperative nutritional support for patients with nutritional risk can improve nutritional indicators,reduce complications and shorten postoperative hospital stay.