心脏手术患者术前营养风险与临床结局关系的研究  

The relationship between nutrition screening before cardiac surgery and adverse clinical outcomes

作　　者：夏萌[1,2] 肖利[1,2] 褚瑶丹 郝佳音[1,2] 康倩[1,2] 李蕾[1,2] 吴小玲[1,2] 习艳霞[1,2] 

机构地区：[1]首都医科大学附属北京安贞医院 [2]北京市心肺血管疾病研究所临床营养科,北京100029

出　　处：《心肺血管病杂志》2014年第2期251-254,共4页Journal of Cardiovascular and Pulmonary Diseases

摘　　要：目的:了解入院时心脏手术患者的营养风险对临床结局的影响。方法:对2012年1月1日至2012年6月30日,在我院心脏外科手术的485例患者进行入院时的营养筛查,采用营养危险筛查2002(nutritional risk screening,NRS2002)量表。NRS评分≥3为有营养风险组(A组),<3为无营养风险组(B组)。观察项目包括:观察一般临床资料(体质量指数、部分血液生化指标等)与营养风险的一致性情况;住院期间患者不良临床结局发生率(住院期间死亡和术后住院时间≥15d);两组患者的住院时间;术后监护时间。结果:①485例手术患者术前NRS2002≥3分者64例,占13.2%。②营养风险评分与入院时的营养指标有非常好的吻合性(P<0.05),如体质量指数、血浆总蛋白、白蛋白、前白蛋白、血红蛋白。③A组发生不良临床结局的可能性明显高于B组;A组患者的监护时间明显比B组延长。两组在住院时间上,差异无统计学意义(P>0.05)。结论:术前有营养风险的患者出现不良临床结局的可能性加大,并且监护时间会明显延长,因此患者术前的营养风险筛查值得医生们重视。Objective：The objective of our study is to investigate the impact of nutritional risk of hospitalized cardiac operation patients on admission on the clinical outcome.Methods：With the application of crosssectional study method totally 485 opened chest patients of the cardiac surgery in our hospital were enrolled from January to June in 2012 to adopt the NRS2002.The patients of NRS score ≥ 3 is classified as nutritional risk group A（group A） while the patients of NRS score ＜ 3 is classified as nutritional risk group B （group B）.Observation items：1.The incidence of adverse clinical outcomes in hospitalized patients （Hospital mortality and postoperative hospitalization time ≥ 15 days）.2.The hospitalization time of two groups of patients.3.He time of guardianship after operation.Results：① 64 cases of 485 cases of preoperative patients with NRS2002 ≥ 3 points are accounted for 13.2％.② Nutritional risk score and nutrition indexes of admission are consistency such as body mass index,serum total protein,albumin,prealbumin,hemoglobin （P ＜ 0.05）.③ The possibility of adverse clinical outcomes in group A was significantly higher than that of B group.The time of guardianship in A group was larger than B group.there is not a significant difference among the two groups of hospitalization time.Conclusion：It will increase that the possibility of adverse clinical outcomes in patients with nutritional risk before heart operation.while the monitored time may be extended.This should arouse the attention before operation for all the medical staff.

关 键 词：营养筛查 心脏外科手术 不良结局 

分 类 号：R54[医药卫生—心血管疾病]