应用NRS2002标准对手术病人营养状况和营养支持的调查  

Nutritional status and nutrition support survey in operative patients by Nutrition Screen 2002

作　　者：陈敏[1] 孙建琴[1] 肖菲[1] 宗敏[1] 李士捷[1] 

机构地区：[1]复旦大学附属华东医院营养科,上海200040

出　　处：《肠外与肠内营养》2009年第3期153-156,159,共5页Parenteral & Enteral Nutrition

摘　　要：目的:应用NRS2002标准对手术病人开展术前营养筛查,以了解该组病人的营养状况,同时进行围手术期营养支持和临床结局调查。方法:收治入院择期手术的127例普通外科、胸外科、妇科和骨科病人参与调查,采用2006年中国肠外肠内营养分会颁布的NRS2002评判标准;同时对病人围手术期营养支持方式、能量、营养素供给和术后并发症、住院时间和药物费用进行调查。结果:需要营养支持的病人占总调查人数的30.7%,其中普通外科占28.3%,高于胸外科(2.4%)、妇科(0%)和骨科(0%)。老年人、恶性肿瘤、腹部大手术病人比例较高,分别为18.1%、19.7%和18.1%,与其他病人比较有显著性差异。7.6%的超重病人术前需制订营养支持计划。围手术期实际开展营养支持者与NRS2002评判结果有较大的差异(P<0.05)。正确实施营养支持者占19.7%,误用营养支持者占11.8%,未用营养支持者占11.0%。营养支持方式单一,以PN支持为主,实施营养支持病人的药物治疗费用、住院时间和术后感染并发症高于未实施的病人。结论:手术病人具有较高的营养不良风险,适宜采用NRS2002这样一个简便、易操作的工具对所有的病人进行营养筛查,并制订出合理的营养支持计划,以减少医疗资源的浪费和感染并发症的发生率。Objective： To apply the NRS2002 to screen the nutritional status of preoperative patients and investigate the nutrition support in the perioperation and clinical outcomes. Methods： 127 selective operational cases （including general surgery, thoracic surgery, gynecology and orthopedic） were recruited to adopte the NRS2002 which issued by CESPN in 2006, and the nutrition support, energy and nutriment in the perioperation, complications, length of stay and drug costs were investigated. Result： 30.7% patients needed nutrition support, with general surgery （ 28. 3% ） being higher than thoracic surgery （2.4%）, gynecology（0% ） and orthopedic （0%）. The nutritional risk in elderly, carcinoma, abdominal operation patients were 18.1% , 19.7% and 18.1% seperately, which was higher than others（P 〈 0.05）. It was still necessary to make a nutrition support plan for those overweighed patients（7.6% ）. There was a quite big difference between the actual support condition and the result of NRS2002 （P 〈0.05）. The percent of the correct implementation of nutrition support, the misuse of nutrition support and the unused nutrition support were 19.7% ,11.8% and 11.0%. The method of nutrition support was quite simplex, only with parenteral nutrition support. In patients who had received PN, the infection complication, length of stay and drug costs were higher than others. Conclusion ： Malnutritional risk is high in operated patients, and NRS2002 is needed to screen the nutritional status of preoperative patients and make a rational support plan to avoid the waste of medical resources and incidence of infection complication.

关 键 词：营养不良风险调查 手术病人 体质指数 营养不良 营养支持 

分 类 号：R459.3[医药卫生—治疗学]