航天中心医院住院患者营养状况调查
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摘要
目的:了解我院妇科、肝胆外科、神经内科、消化科、粘液瘤科住院患者营养不良、营养风险、营养医嘱及营养支持情况。方法:患者入院后第2天进行营养风险筛查(NRS 2002)判断是否需要营养支持;病历系统中收集患者职业、婚姻、年龄、住院日、白蛋白、饮食医嘱及营养支持相关数据。结果:住院患者以退休、已婚、摄食量不变、体重无变化者居多;平均住院日粘液瘤科最长(13. 77±10. 51d),妇科最短(6. 00±3. 79d);平均年龄神经内科最大(63. 38±16. 57岁),妇科最小(39. 18±11. 94岁)。营养不良比例最高的是消化科(76. 92%),最低的是妇科(8. 16%)。住院患者总营养风险发生率为40. 32%,其中粘液瘤科最高(59. 09%),妇科最低(10. 2%)。各科饮食医嘱差异有统计学意义(P=0. 000 <0. 05),177例(40. 78%)根据病情变化调整膳食医嘱。肠内营养制剂使用比例最高的是神经内科(38. 71%),其他科室均未使用;肠外营养制剂各科室使用比例均较高。有营养风险者平均营养支持率为57. 14%,其中最高的是肝胆外科(85. 46%),最低的是妇科(20%)。结论:住院患者营养不良及营养风险发生率较高;肠内营养使用率过低,肠外营养使用率过高,急需推广肠内营养治疗;有营养风险者营养支持率有待提高。
Objective To understand the incidence of malnutrition and nutritional risk,nutritional advice and nutritional support of patients in department of gynecology,liver and gallbladder surgery,neurology,gastroenterology and myxoma. Method Nutritional risk screening( NRS 2002) done in the second day after patients admitted to hospital to determine whether patients need nutritional support. Using medical record system to collect related data,such as patients' career,marriage,age,length of stay in hospital,albumin,dietary advice and nutritional support. Result Most patients in our hospital were retired,married,appetite unchanged,and weight unchanged. The longest average length of stay was myxoma department( 13. 77 ± 10. 51 days),the shortest was gynecology department( 6. 00 ± 3. 79 days). The largest average age was neurology department( 63. 38 ± 16. 57 years),the minimum was gynecology department( 39. 18 ± 11. 94 years). The highest percentage of malnutrition was gastroenterology department( 76. 92%),and the lowest was gynecology department( 8. 16%). Total nutritional risk incidence was 40. 32%,the highest was myxoma department( 59. 09%) and the lowest was gynecology department( 10. 2%).Diet advice in different department was statistically significant( P = 0. 000 < 0. 05),177 cases( 40. 78%) changed the diet advice according their state. The highest percentage of using enteral nutrition was neurology department( 38. 71%),other departments were not used. All departments frequently used parenteral nutrition. 57. 14 percentage nutritional risk patients accepted nutritional support,the highest was liver and gallbladder surgery department( 85. 46%),and the lowest was gynecology department( 20%). Conclusion The incidence of malnutrition and nutritional risk was higher. Enteral nutrition utilization rate was low,parenteral nutrition utilization rate was too high,promotion of enteral nutrition therapy be badly in need. Nutritional support need to be improved in patients with nutritional risk.
Objective To understand the incidence of malnutrition and nutritional risk,nutritional advice and nutritional support of patients in department of gynecology,liver and gallbladder surgery,neurology,gastroenterology and myxoma. Method Nutritional risk screening( NRS 2002) done in the second day after patients admitted to hospital to determine whether patients need nutritional support. Using medical record system to collect related data,such as patients' career,marriage,age,length of stay in hospital,albumin,dietary advice and nutritional support. Result Most patients in our hospital were retired,married,appetite unchanged,and weight unchanged. The longest average length of stay was myxoma department( 13. 77 ± 10. 51 days),the shortest was gynecology department( 6. 00 ± 3. 79 days). The largest average age was neurology department( 63. 38 ± 16. 57 years),the minimum was gynecology department( 39. 18 ± 11. 94 years). The highest percentage of malnutrition was gastroenterology department( 76. 92%),and the lowest was gynecology department( 8. 16%). Total nutritional risk incidence was 40. 32%,the highest was myxoma department( 59. 09%) and the lowest was gynecology department( 10. 2%).Diet advice in different department was statistically significant( P = 0. 000 < 0. 05),177 cases( 40. 78%) changed the diet advice according their state. The highest percentage of using enteral nutrition was neurology department( 38. 71%),other departments were not used. All departments frequently used parenteral nutrition. 57. 14 percentage nutritional risk patients accepted nutritional support,the highest was liver and gallbladder surgery department( 85. 46%),and the lowest was gynecology department( 20%). Conclusion The incidence of malnutrition and nutritional risk was higher. Enteral nutrition utilization rate was low,parenteral nutrition utilization rate was too high,promotion of enteral nutrition therapy be badly in need. Nutritional support need to be improved in patients with nutritional risk.
引文
[1] Raja R,Lim AV,Lim YP,et al. Malnutrition screening I hospitalized patients and its implication on reimbursement[J]. Intern Med J,2004,34(4):176-181.
[2]陈伟,蒋朱明,张永梅,等.欧洲营养不良风险调查方法在中国住院患者的临床可行性研究[J].中国临床营养杂志,2005,13(3):137-141.
[3] Fine JT,Coliditz GA,Coakley EH,et al. A prospective study of weight change and health—related quality of 1ife in women[J]. Intem Med J,2004,34(4):176-181.
[4] Saletti A,Johansson L,Yifter-Lindgren E. Nutritional state and a 3-year f0iiow-up in elderly receiving support at hot[J]. Gerontology,2005,51(3):192-198.
[5] Koretz RL,Lipman TO,Klein S. AGA technical review on parenteral nutrition[J]. Gastroenterology,2001,121(4):970-1001.
[6] Klein S,et al. Nutrition support in clinical practice:Review of pub washed data and recommendations for future research direction[J]. JPEN,1997(21):133-156.
[7]陈凌. ESPEN营养风险筛选(NRS 2002)-循证的方法及在欧洲的应用[J].中国临床营养杂志,2007,4(2):4.
[8]蒋朱明.肠外肠内营养循证应用和研究进展[M].北京:中华医学电子音像出版,2006:5-8.
[9]毕研霞,洪忠新,张立红,等.肿瘤化疗患者营养风险评估及影响因素分析[J].中国食物与营养,2018,24(3):66-70.
[2]陈伟,蒋朱明,张永梅,等.欧洲营养不良风险调查方法在中国住院患者的临床可行性研究[J].中国临床营养杂志,2005,13(3):137-141.
[3] Fine JT,Coliditz GA,Coakley EH,et al. A prospective study of weight change and health—related quality of 1ife in women[J]. Intem Med J,2004,34(4):176-181.
[4] Saletti A,Johansson L,Yifter-Lindgren E. Nutritional state and a 3-year f0iiow-up in elderly receiving support at hot[J]. Gerontology,2005,51(3):192-198.
[5] Koretz RL,Lipman TO,Klein S. AGA technical review on parenteral nutrition[J]. Gastroenterology,2001,121(4):970-1001.
[6] Klein S,et al. Nutrition support in clinical practice:Review of pub washed data and recommendations for future research direction[J]. JPEN,1997(21):133-156.
[7]陈凌. ESPEN营养风险筛选(NRS 2002)-循证的方法及在欧洲的应用[J].中国临床营养杂志,2007,4(2):4.
[8]蒋朱明.肠外肠内营养循证应用和研究进展[M].北京:中华医学电子音像出版,2006:5-8.
[9]毕研霞,洪忠新,张立红,等.肿瘤化疗患者营养风险评估及影响因素分析[J].中国食物与营养,2018,24(3):66-70.