小儿外科住院患者营养不良与超重肥胖对住院经济的影响

The Effect of Malnutrition and Overweight and Obesity on Hospitalization Economy in Pediatric Surgical Inpatients

目的 研究小儿外科住院患者不同营养水平对住院天数、住院费用的影响。方法 选取泉州市妇幼保健院·儿童医院2018年11月1日—2019年10月31日收治的2 088例小儿外科住院患者,按营养水平不同分为正常、营养不良、超重肥胖3组,分别为1 872例、144例、72例。0~5岁用2007年WHO判定标准,> 5~18岁按WS/T 456—2014《学龄儿童青少年营养不良筛查》、WS/T 586—2018《学龄儿童青少年超重与肥胖筛查》判定标准。3组均接受常规外科手术治疗,比较3组住院天数、住院费用的差异。结果 小儿外科住院患者营养不良占比和超重肥胖占比分别为6.9%和3.4%。各年龄段与男女间营养不良占比差异无统计学意义(P> 0.05);>5~18岁超重肥胖占比(7.9%)高于0~1岁组(2.3%)和> 1~5岁组(1.6%)(P <0.05)。> 5~18岁男性超重肥胖占比(9.7%)高于女性(1.7%)(P <0.05);营养不良组住院天数、住院总费用高于超重肥胖组与正常组。结论 泉州市妇幼保健院·儿童医院小儿外科> 5~18岁男性住院患儿的超重肥胖占比较高,应引起注意,为后续临床营养科在该科专题宣教的重点人群;营养不良可影响临床结局,对患儿进行入院前的营养水平评估,发挥临床营养科的积极干预作用,应成为临床诊疗服务过程中的一个重要环节。

Objective To study the effect of different nutritional levels on hospitalization days and hospitalization expenses in pediatric surgical inpatients.Methods A total of 2 088 pediatric surgery inpatients admitted to Quanzhou Women and Children's Hospital and Children's Hospital from November 1,2018 to October 31,2019 were selected and divided into 3 groups according to different nutritional levels,normal,malnourished,overweight and obese,with 1 872 cases,144 cases and 72 cases,respectively.The age of 0-5 years old was determined by the 2007 WHO criteria,and the age of > 5-18 years old was determined by WS/T 456—2014' Malnutrition Screening for School-age Children and Adolescents' and WS/T 586—2018' Overweight and Obesity Screening for School-age Children and Adolescents'.All three groups received routine surgical treatment,and the differences in hospitalization days and hospitalization expenses between the three groups were compared.Results The proportion of malnutrition and overweight and obesity in pediatric surgical inpatients was 6.9% and 3.4%,respectively.There was no significant difference in the proportion of malnutrition among different age groups and between men and women(P > 0.05).The proportion of overweight and obesity in > 5-18 years old group(7.9%) was higher than that in 0-1 years old group(2.3%) and > 1-5 years old group(1.6%)(P < 0.05).The proportion of overweight and obesity in males aged > 5-18 years(9.7%) was higher than that in females(1.7%)(P < 0.05).The hospitalization days and total hospitalization expenses in the malnutrition group were higher than those in the overweight and obesity group and the normal group.Conclusion The high proportion of overweight and obesity in male hospitalized children aged > 5-18 years in the department of pediatric surgery,Quanzhou Women and Children's Hospital should be paid attention to,and it should be the key population for the follow-up clinical nutrition department to carry out special education in this department.Malnutrition can affect the clinical outcome.It should be an important part of the clinical diagnosis and treatment service process to evaluate the nutritional level of patients before admission and give full play to the positive intervention role of clinical nutrition department.