不同营养评价方法对超高龄患者压疮评估的临床价值比较  

Comparison of the cfinical value among different nutritional evaluation methods for super aging patients with high risk of pressure ulcers

作　　者：董萍[1] 闫雪娇[1] 王蕾[2] 

机构地区：[1]北京医院保健医疗部,100730 [2]北京医院护理部,100730

出　　处：《中华现代护理杂志》2015年第13期1498-1503,共6页Chinese Journal of Modern Nursing

基　　金：卫生部北京医院院级科研课题（BJ-2012-93）

摘　　要：目的探讨主观全面营养评价方法（SGA）、微型营养评价方法（MNA—SF）、营养风险筛查2002（NRS2002）对102例超高龄（80-90岁之间）住院患者中压疮的发生与营养评估方法的应用效果。方法采用便利抽样的方法，选取2012年8月—2014年12月住院患者102例，根据3种营养评估方法进行营养筛查，记录压疮的结果。结合传统测量方法和化验室指标比较他们之间的相关性，结合ROC比较在压疮评估的敏感性、特异性的不同，对营养评价方法优缺点展开评述。结果在高龄患者中，压疮的发生率为35．29％，MNA—SF、NRS2002、SGA评价方法检出营养不良的检出率分别为74．5％，54．9％和29．4％。MNA—SF在营养筛查的检出率要高于其他两种，同时3种营养评价方法与传统测量方法及实验室指标评定结果呈负相关（P〈0．05），在评估营养风险或者营养不良与营养正常的组间压疮发生率的差异均有统计学意义（P〉0．05），在评估压疮发生的敏感性上，MNA—SF为86．1％，而NRS2002为61．0％，SGA为33．3％，特异性3种评价方法分别为68．2％，51．5％，27．3％。结论在营养筛查上MNA—SF在判断营养与压疮的效果方面稍好于SGA和NRS2002。Objective To explore the pressure ulcer incidence and nutrition evaluation of 102 hospitalized super aging patients （80 -90 year-old） by the subjective comprehensive nutrition evaluation method （SGA）, the micro-nutrition evaluation method （MNA-SF）, and nutritional risk screening 2002 （NRS 2002 ）. Methods A total of 102 hospitalized super aging patients had been selected by the convenient sampling method and documented the incidence pressure ulcer according to three methods of nutritional screening from August 2012 to December 2014. We combined with the traditional measurement methods and laboratory index to compare the correlation between them, and combined with the ROC to evaluate the sensitivity and specificity of different pressure ulcers. The evaluation of the advantages and disadvantages were also discussed. Results In elderly patients, the incidence of pressure ulcers was 35.29%, the detection rate of MNA-SF, NRS 2002, SGA evaluation methods in malnutrition were 74. 5%, 54. 9% and 29. 4%. The MNA-SF detection rate of malnutrition was higher than the other two methods. All three nutrition detection methods had negative correlation with traditional nutrition measurement and indexes results of laboratory （ P 〈 0. 05 ）, and had statistical significance at assessment of nutrition risk, malnutrition, normal nutrition with incidence rate of pressure ulcer （ P 〉 O. 05 ）. While we assessed the sensitivity of pressure ulcer, the MNA-SF was 86.1%, NRS 2002 61.0%, SGA 33.3%, and the three specificity were 68.2%, 51.5%, 27.3%. Conclusions MNA-SF has a better effect than SGA and NRS 2002 at detection of malnutrition and the effect of pressure ulcer.

关 键 词：压疮 营养风险筛查 微型营养评价方法 主观全面营养评价方法 超高龄 

分 类 号：R473[医药卫生—护理学]