欧洲营养风险筛查2002与微型营养评价法在脑卒中吞咽障碍患者营养状况评价中的应用  

Application of NRS-2002 and MNA in the nutriture

作　　者：张敏[1] 郝艳青[1] 刘秀[2] 孙铮[1] 

机构地区：[1]泰山医学院人口与计划生育学院,泰安271000 [2]山东省泰安市中医二院护理部,271000

出　　处：《中华现代护理杂志》2013年第7期764-767,共4页Chinese Journal of Modern Nursing

基　　金：泰安市科学技术发展计划（20113040）

摘　　要：目的探讨欧洲营养风险筛查2002（NRS-002）与微型营养评价法（MNA）在脑卒中吞咽障碍患者中进行营养风险筛查的适用性，及其与传统营养评价指标的相关性。方法采用便利随机抽样法，选择脑卒中吞咽障碍患者70例为研究对象，利用NRS-2002、MNA量表进行营养状况评估，同时测量传统营养评价指标，并进行统计学处理，分析其相关性。结果MNA调查结果显示，营养不良的患病率为10．0％，潜在营养不良患病率为42．9％，营养正常的为47．1％。NRS-2002调查结果显示，营养风险的患病率为41．4％，营养正常的为58．6％。NRS-2002、MNA与传统营养评价法中的体重指数、肱三头肌皮褶厚度、上臂肌围、腓肠肌围、血红蛋白、总蛋白、白蛋白、前白蛋白及总淋巴细胞数呈显著相关，相关系数（r）分别为-0．618-0．393及0．411—0．668（P〈0．05）。以传统营养评价法为标准MNA、NRS-2002的灵敏度分别为83．3％，77．8％；特异度为57．7％，71．2％；Kappa值分别为0．31，0．41。结论脑卒中吞咽障碍患者营养不良的发生率较高，NRS-2002是较MNA及传统营养评价法评价脑卒中吞咽障碍患者营养状况更快速有效的方法，可有效应用于脑卒中吞咽障碍患者营养状况的评价。Objective To identify the applicability of mini - nutritional assessment （ MNA）, and nutrition risk screening2002 （NRS-2002） on screening nutrition risk in stroke patients with dyphagia, and the relationship among MNA, NRS-2002 and traditional nutritional assessment. Methods Convenient random sampling method was used to select 79 stroke patients with dyphagia as the research objects. NRS-2002 and MNA was used to assess their nutriture and traditional nutritional evaluation indexes were observed. The correlation between MNA, NRS-2002 and traditional nutritional assessment was analyzed. Results MNA showed that the prevalence of malnutrition was 10.0% , the potential risk was 42.9% and the normal nutrition was 47.1%. NRS-2002 showed that the potential risk was 41.4% and the normal nutrition was 58.6%. The correlation coefficients of indexes including BMI, TSF, AMC, CC, Hb, TP, Alb, PA and LC were 0. 411 - 0. 668 （ P 〈 0.01 ） between MNA and traditional nutritional assessment. And the correlation coefficients of indexes including BMI,TSF,AMC, CC, Hb,TP,Alb, PA and LC were - 0. 618 - - 0. 393 （P 〈 0.01 ） between NRS- 2002 and traditional nutritional assessment. Taking traditional nutrition evaluation as the standard, the sensitivities of MNA and NRS-2002 were 88.3% and 77.8%, the specificities were 57.7% and 71.2% ,and the Kappa values were 0.31 and 0.41 respectively. Conclusions Malnutrition is a common problem in stroke patients with dyphagia. NRS-2002 is a more rapid and effective method to assess patients＇ nutriture than MNA and traditional nutritional assessment, thus can be applied to the nutritional assessment in stroke patients with dyphagia.

关 键 词：卒中 吞咽障碍 营养评价 微型营养评价法 营养风险筛查2002 

分 类 号：R45[医药卫生—治疗学] R74[医药卫生—临床医学]