RFH-NPT及RFH-GA在失代偿期肝硬化患者营养评估中的应用价值

The value of RFH-NPT and RFH-GA on evaluating the nutritional status in patients with decompensated liver cirrhosis

[目的]应用皇家自由医院营养优先工具(RFH-NPT)进行营养风险筛查以及皇家自由医院全面评定(RFH-GA)营养评估工具对失代偿期肝硬化住院患者进行营养状况调查,分析这2种工具及这2种工具联合构建的评估系统对评价肝硬化失代偿期患者营养状况的应用价值。[方法]选取肝硬化失代偿期患者100例作为研究对象,在入院24~48 h内通过查阅患者病历、现场咨询,收集患者基本信息资料并分别用RFH-NPT进行营养风险筛查和RFH-GA进行营养评估。[结果]100例患者经RFH-NPT筛查出无营养风险者14例,有营养风险者86例;经RFH-GA评估为营养良好者21例,中度或可疑营养不良者60例,重度营养不良者19例。重度营养不良者的体质指数、上臂围、三头肌皮褶厚度、上臂肌围、血清白蛋白水平等显著低于营养良好、中度或可疑营养不良者(P<0.01)。患者的营养综合评估状况与患者的体质指数、上臂围、三头肌皮褶厚度、上臂肌围、血清白蛋白水平呈负相关,与淋巴细胞水平呈正相关。随着营养状态的改变,腹水、感染并发症的发生率逐渐升高,差异有统计学意义(P<0.05)。[结论]序贯联合应用RFH-NPT及RFH-GA适用于评价肝硬化失代偿期患者的营养状况。

[Objective]To investigate Royal free hospital-nutritional prioritizing tool(RFH-NPT)nutrition risk screening tools and Royal free hospital-global assessment(RFH-GA)nutritional assessment tools on evaluating the nutritional status in patients with decompensated liver cirrhosis, and their application value.[Methods]One hundred hospitalized patients with decompensated liver cirrhosis were selected.RFH-NPT and RFH-GA were used to evaluate the nutritional status in the patients within 24-48 hours after their admission.The patient’s medical records, on-site consultation, basic patient information were recovded.[Results]In the hospitalized patients with decompensated liver cirrhosis, the RFH-NPT screening showed a high nutritional risk in 86 patients.According to RFH-GA assessment diagnosed to patiercts with moderate or suspected malnutrition, and 19 patients had severe malnutrition.RFH-NPT indicated that patients at high nutritional risk and RFH-GA evaluated severely malnourished patients had significantly lower levels of BMI,AC,TSF,AMC,ALB than the other two groups(P<0.01).The patient’s comprehensive nutritional assessment status was negatively correlated with the patient’s BMI,AC,TSF,AMC,and ALB levels, and positively correlated with the LY level.With the change of nutritional status, the incidence of ascites and infection complications gradually increased, and the difference was statistically significant(P<0.05).[Conclusion]The sequential combined application of RFH-NPT and RFH-GA is suitable for evaluating the nutritional status of patients with decompensated liver cirrhosis.