普外科住院患者营养状况评价及预后分析  

Prevalence of malnutrition in general surgical patients: evaluation of nutritional status and prognosis

作　　者：吴国豪[1] 刘中华[1] 郑烈伟[1] 全应军[1] 吴肇汉[1] 

机构地区：[1]复旦大学附属中山医院普外科,上海200032

出　　处：《中华外科杂志》2005年第11期693-696,共4页Chinese Journal of Surgery

摘　　要：目的探讨外科住院患者营养状况与手术后并发症发生率及死亡率的关系。方法采用多项营养评价指标测定4012例普外科非急诊住院患者营养状况,分析患者营养状况与死亡率、并发症关系。结果各项营养指标检测的营养不良发生率分别是:体重指数21.3%,三头肌皮褶厚度50.6%,上臂围20.5%,上臂肌围21.2%,主观全面评价法38.0%,微型营养评价法20.8%,ALB24.2%,PA35.4%,TLC55.8%。>60岁组老年患者、消化道疾病患者及恶性肿瘤患者营养不良发生率分别高于≤60岁、消化道外疾病及良性疾病患者,差异具有统计学意义(P<0.05)。营养不良患者的并发症发生率及死亡率均明显高于营养状况良好者(P<0.01),而且住院时间明显延长(P<0.05)。结论营养不良患者的手术后死亡率、并发症发生率和住院时间均高于营养状况良好者。Objective To estimate prevalence of malnutrition on admission to hospital and the relationship between nutritional status and prognosis. Methods Four thousand and twelve patients admitted to general surgery department were evaluated by a lot of nutrition indexes within 48 h. Operative morbidity and complications were recorded to identify the difference between malnourished and well-nourished patients. Results Malnutrition rate of all patients according to BMI, TSF, MAC, AMC, albumin, prealbumin, and lymphocyte count was 21.3%, 50.6%, 20.5%, 21.2%, 24.2%, 35.4% and 55.8%, respectively. The prevalence of malnutrition as defined by SGA and MNA were 38.8% and 20.8%. The older patients (>60 years old) were associated with a higher prevalence of malnutrition (47.6%) compared with those younger than 60 (31.5%). Malnutrition was more frequently occurred in cancer patients than non-oncologic patients (64.5% vs 22.4%). Patients with digestive tract disease had higher rates of malnutrition than those without digestive tract disease (52.6% vs 30.0%). There were large differences in the morbidity and complications between well nourished patients and malnourished patients (4.0% vs 1.1%, P<0.01 for morbidity; 19.8% vs 5.9% for complications). Conclusions The prevalence of malnutrition in hospitalized surgical patients is high. Malnutrition was associated with increased length of stay, higher operative morbidity and complications.

关 键 词：外科住院患者 营养状况评价 预后分析 并发症发生率 三头肌皮褶厚度 营养不良 恶性肿瘤患者 消化道外疾病 疾病患者 住院时间 营养评价法 术后死亡率 指标测定 体重指数 指标检测 上臂肌围 老年患者 60岁 手术后 普外科 

分 类 号：R619[医药卫生—外科学]