基层医院不同种类手术患者术前营养状况评价及敏感指标初探  

Preoperative Nutritional Evaluation and the Sensitivity Index for the Patients with Different Operations in Primary Hospital

作　　者：赵晓艳 

机构地区：[1]盱眙县人民医院麻醉科,江苏盱眙211700

出　　处：《医学综述》2014年第10期1918-1920,共3页Medical Recapitulate

摘　　要：目的比较不同种类手术患者术前的营养状况,并探讨反映患者术前营养状况的敏感指标。方法选择盱眙县人民医院2009年1月至2010年5月行手术治疗的患者285例,根据手术类型被分为四组:骨折手术89例(骨折组)、良性肿瘤切除术89例(良性组)、恶性肿瘤切除术65例(恶性组)、其他手术42例(其他组)。比较各组患者术前的血清蛋白(TP)、白蛋白(Alb)、血红蛋白(Hb)和总淋巴细胞计数(TLC)及各组患者的营养不良率。结果各组TP水平比较差异有统计学意义(P<0.05),骨折组水平最低,与其他三组比较差异有统计学意义(P<0.05)。各组以TP判断营养不良率比较差异有统计学意义(P<0.05),且骨折组营养不良率显著高于其他三组(P<0.01);各组以TLC判断营养不良率和临界营养不良率比较差异有统计学意义(P<0.05),且良性组的营养不良率显著低于其他三组(P<0.01),临界营养不良率显著高于其他三组(P<0.01)。结论基层医院手术患者术前均存在一定程度的营养不良,尤其应重视骨折患者的营养问题。在TP、Alb、Hb和TLC中,用TLC判断的营养不良率最高,TP是判断骨折患者营养状况的敏感指标。Objective To compare the preoperative nutritional status of the patients with different operations,and find the sensitivity indicators.Methods A total of 285 surgical patients were selected from Xuyi County People＇s Hospitalduring Jan.2009 and May 2010,and were divided into four groups：89 cases in fracture group,89 cases in benign tumor group,65 cases in malignant tumor group and 42 cases in other operations group.The level of serun total protein（TP）,albunin（Alb）,lymphocyte count（TLC） and hemoglobin（Hb） and malnutrition rate of different groups before operation were compared.Results The TP levels of different groups were statistically significantly different（P 〈 0.05）,the level of the fracture group was the lowest,with statistically significantly difference from the other three groups（P 〈 0.05）.malnutrition rate judged by TP of different groups had statistically significant difference（P 〈 0.05）,and the malnutrition rate of the fracture group was significantly higher than the other three groups（P 〈 0.01） ; the malnutrition rate and critical malnutrition rate judged by TLC of different groups had statistically significant difference（P 〈 0.05）,and the malnutrition rate of the benign tumor group was lower than the other three groups （P 〈 0.01）,the critical malnutrition rate of the benign tumor group was significantly higher than the other three groups（P 〈 0.01）.Conclusion A certain degree of malnutrition exist in the patients before operations in the primary hospital,especially in the patients for fracture operation,which should not be neglected.Among TP,Alb,Hb and TLC,the malnutrition rate judged by TLC is the highest,and TP is a sensitive index for the nutritional evaluation in the patients for fracture operation.

关 键 词：术前 营养不良 血清蛋白 白蛋白 血红蛋白 总淋巴细胞计数 

分 类 号：R151.42[医药卫生—营养与食品卫生学]