不同营养评价工具在消化道肿瘤患者中应用的比较  

Comparison of two nutritional evaluation tools in gastrointestinal cancer patients

作　　者：迟俊涛[1] 高凤莉[2] 宋振兰[4] 鲁重美[3] 

机构地区：[1]北京协和医学院护理学院,100144 [2]北京协和医院医务处,100730 [3]北京协和医院消化内科,100730 [4]烟台毓璜顶医院护理部,264000

出　　处：《中华现代护理杂志》2010年第7期748-751,共4页Chinese Journal of Modern Nursing

摘　　要：目的比较主观全面营养评价法（Subjective Global Assessment，SGA）和营养风险筛查2002（Nutritional Risk Screening2002，NRS2002）在消化道肿瘤患者中应用的差异性和一致性。方法采用横断面调查223例消化道肿瘤患者，于人院48h内采用SGA和NRS2002进行营养状态评价。分别采用配对χ2和Kappa检验比较两种评价工具之间的差异性和一致性。结果223例患者均完成SGA和NRS2002营养状态评价，SGA评价营养不良发生率为32．3％，NRS2002为61％，差异有统计学意义（P〈0．01）。两种工具对营养状态的评价虽然存在一致性（P〈0．01），但一致性差（Kappa=0．368）。结论SGA和NRS2002均可用于消化道肿瘤患者营养状态的评价，但两者的评价结果存在差异性，NRS2002易于发现早期营养不良的患者，有利于营养不良的预防，SGA则侧重于营养不良的治疗。Objective To compare diversity and diagnostic concordance of Subjective Global Assessment （SGA） with Nutritional Risk Screening 2002 （NRS2002） in evaluating nutritional status among gastrointestinal cancer patients. Methods Two hundred and twenty-three patients with gastrointestinal cancer were conveniently selected and evaluated by SGA and NRS within 48h of admission from April to October 2009 using cross-sectional study. Diversity and diagnostic concordance between SGA and NRS2002 were analyzed by McNemar paired chisquare test and Kappa test. Results All patients completed both NRS2002 and SGA. The prevalence of nutritional risk or undernutrition evaluated by NRS2002 or SGA was 61% versus 32.3%. There was a significant difference between NRS2002 and SGA after conducting McNemar paired chi-square test （P 〈 0. 01 ） but diagnostic concordance of SGA and NRS2002 was poor （ Kappa = 0. 368, P 〈 0. 01 ）. Conclusions Both NRS2002 and SGA were feasible in evaluating nutritional status in gastrointestinal cancer patients, but there was deference between NRS2002 and SGA. NRS2002 had higher sensitivity to detect early under nutrition and was more suitable in prevention under nutrition than SGA in gastrointestinal cancer patients.

关 键 词：消化道肿瘤患者 营养评价 主观全面营养评价法 营养风险筛查 

分 类 号：R473.73[医药卫生—护理学]