神经外科重症患者营养风险和营养支持情况调查研究

Investigation of nutrition risk and nutrition support among severe inpatients in department of neurology

目的分析神经外科重症患者营养风险和营养支持应用情况。方法回顾性调查2015年1月至2016年1月山西医科大学第一医院神经外科重症住院患者98例,对其应用营养风险筛查2002进行营养风险评估,统计营养风险发生率以及14 d内的营养支持应用状况。结果营养风险发生率为45.91%(45/98),营养风险组接受营养支持率为64.44%,无营养风险组接受营养支持率为52.83%。在98例患者中有57例接受营养支持,所有接受营养支持的患者大多数单独使用肠内营养支持方式。组间比较:风险组较无风险组营养指标前白蛋白1 d时明显降低,总蛋白、白蛋白、前白蛋白14 d时明显降低,差异具有统计学意义(P<0.05)。组内比较:风险组14 d时总蛋白、白蛋白、前白蛋白明显降低,无风险组14 d时总蛋白、白蛋白明显降低,差异具有统计学意义(P<0.05)。风险组相关并发症(吸入性肺炎、呕吐及腹泻)共18例,占40.0%,无风险组共9例,占16.98%,两组差异有统计学意义(χ~2=6.460,P<0.05)。结论患者营养风险率较高,同时患者接受营养支持应用率也相对较高,均以肠内营养支持为主。

Objective To analyze the incidence of nutrition risk and the application of nutrition support with severe patients of neurosurgery. Methods Ninety-eight severe patients in Department of Neurosurgery, the First Hospital of Shanxi Medical University from January 2015 to January 2016 were used the nutrition risk screening 2002 for evaluating nutritional risk and surveying the incidence of nutritional risk as well as the condition of nutrition support application within 14 days through retrospective analysis. Results Forty-five patients in 98 cases had nutrition risk, the incidence was 45.91%(45/98). The incidence of patients, received nutrition support, of nutrition risk and risk-free were 64.44% and 52.83%. 57 patients among 98 were received nutrition support, of which major patients were used the enteral nutrition support. The number of prealbumin in nutrition risk groups were obviously decreased at first day, total protein, albumin and prealbumin were markedly lower at fourteen days, in the meantime, the first two were the same in nutrition risk-free groups, there were statistical significance(all P<0.05). 18 patients in nutrition risk groups had complications, such aspiration pneumonia, emesis and diarrhea, the proportion 40.0%, in comparison, the proportion was 16.98% in 9 patients nutrition risk-free groups, there were statistical significance between the two groups(P<0.05). Conclusion These severe patients of this hospital neurosurgery had a high frequency of nutrition risk, while these patients were a high proportion in applying nutrition support in term of enteral nutrition support.