营养支持对有营养风险患者临床结局影响的队列研究  

Effects of nutritional support on clinical outcome in patients with nutritional risk: a cohort study

作　　者：闫晶晶[1] 牟绍玉[1] 张慧[1] 牟绍兰[1] 

机构地区：[1]重庆医科大学护理学院,重庆400016

出　　处：《重庆医科大学学报》2014年第6期892-895,共4页Journal of Chongqing Medical University

基　　金：重庆市科委科技公关计划资助项目(编号:cstc2012gg-yyjs1001)

摘　　要：目的:探讨营养支持对有营养风险患者临床结局的影响。方法:采用前瞻性队列研究方法,应用营养风险筛查工具(nutritional risk screening tool 2002,NRS 2002)对重庆某三甲医院消化内科和胃肠外科部分住院患者进行营养风险筛查。将NRS评分≥3分的患者,以有、无营养支持分为2个队列,观察记录2队列患者的临床资料,分析营养支持对营养风险患者的并发症、住院时间的影响。结果:筛查1490例患者,共440例营养风险患者纳入队列研究,其中有营养支持队列186例(42.3%),无营养支持队列254例(57.7%);2队列共发生并发症70例(10.9%),其中营养支持队列19例(10.2%),无营养支持队列51例(20.1%),差异有统计学意义(P=0.005);有、无营养支持两队列患者的住院时间分别为(12.8±3.9)、(15.6±6.1)d,差异有统计学意义(t=5.937,P=0.000)。营养风险患者感染性并发症影响因素的回归分析显示:营养不良、体质量严重下降、营养支持及接受腹部大手术与营养风险患者的感染性并发症发生率有关,营养支持是其保护因素。结论:合理的营养支持能降低营养风险患者并发症发生率,缩短住院时间,应对住院患者常规进行营养风险筛查,并按肠外肠内营养指南规范营养支持。Objective：To investigate the effects of nutritional support on clinical outcomes in patients with nutritional risk. Methods：Method of prospective cohort study was adopted. Nutritional risk of patients in the department of gastroenterology and department of gastrointestinal surgery was assessed by applying the nutritional risk screening tool 2002（NRS 2002）. Patients with NRS score ≥3were divided into two groups by the presence of nutritional support. Clinical data of the two groups were observed and recorded. Influence of nutritional support on complications and hospitalization time in patients with nutritional risk were analyzed. Results：Totally1 490 patients were screened and 440 patients were included in the cohort study,including 186 patients（142.3%）in nutritional support group and 254 patients（57.7%）in non-nutritional support group. Complications were occurred in 70 patients,including 19 patients（10.2%）in nutritional support group and 51 patients（20.1%）in non-nutritional support group,with statistically significant differences between two groups（P=0.005）. The length of hospital stay was（12.8±3.9）d in nutritional support group and（15.6±6.1）d in non-nutritional support group,with statistically significant differences between two groups（t=5.937,P=0.000）. Logistic regression analysis of patients with infectious complications showed that malnutrition,a serious decline in body weight,nutritional support and acceptance of major abdominal surgery were related with the incidence of infectious complications and nutritional support was a protective factor. Conclusion：Proper nutritional support can reduce the incidence of complications in patients with nutritional risk and shorten the length of hospital stay. Early nutritional risk screening should be conducted. Giving effective nutritional interventions timely to the nutritional-risk patients will be of great significance.

关 键 词：营养支持 营养风险 临床结局 队列研究 

分 类 号：R151.4[医药卫生—营养与食品卫生学]