NRS 2002在食管癌放疗患者营养筛查中的应用实践  

Application of Nutrition Risk Screening 2002 in nutrition screening for patients with esophageal cancer

作　　者：朱云霞[1] 谢淑萍[1] 叶青[1] 陈雅情 夏黎瑶 沈平群[1] 

机构地区：[1]浙江省肿瘤医院胸部放疗科,杭州市310022

出　　处：《中华全科医学》2015年第10期1712-1714,共3页Chinese Journal of General Practice

基　　金：浙江省医药卫生科技计划项目(2012KYA024)

摘　　要：目的探讨持续质量改进(CQI)方法推进欧洲营养风险筛查2002在食管癌放疗患者营养筛查中的应用效果,规范食管癌放疗患者营养风险筛查程序,提高临床营养评估质量。方法对浙江省肿瘤医院胸部肿瘤放疗科行放射治疗的102例食管癌患者以持续质量改进方法每周应用NRS 2002进行营养风险筛查,结合人体测量指标、实验室检查数据进行营养评估,分析其相关性,并评价NRS 2002敏感性和特异性。结果患者放疗开始后营养不良风险逐步增加,与入院时比较,差异有统计学意义(P<0.05);NRS 2002与BMI、TSF、AC、AMC有相对较强的负相关性(P<0.05),与前白蛋白有相对较弱的负相关性(P<0.05);以血清白蛋白为标准,测得NRS 2002的敏感度为95.3%,特异度为80.08%,阳性预测值为74.3%,阴性预测值为96.67%。通过培训与实践,临床护士营养筛查、营养评价能力提高。结论 NRS 2002在食管癌放疗患者营养风险筛查中的应用易于掌握,具有较高的敏感性和特异性,能够作为放疗患者营养不良风险的筛查工具;持续质量改进方法有利于临床护士掌握营养筛查工具的应用,促进营养监测和护理干预。Objective To explore the application of Europe Nutrition Risk Screening 2002 （ NRS 2002） by using the continuous quality improvement among esophageal cancer patients who accepted radiotherapy, standardize the screening procedure for stomach nutritional risk, and improve the quality of nutritional status assessment. Methods NRS 2002 was used weekly in the continuous quality improvement to screen the 102 esophageal cancer patients who accepted radiotherapy in Zhejiang cancer hospital, the anthropometry and biochemistry indexes were also included to analyze its correlation with NRS 2002. The sensitivity, specificity and positive/negative predictive values of NRS 2002 were discussed. Results The prevalence of nutritional risk increased. When comparedwith the value at the admission, the difference was statistically significant（ P 〈0.05 ）. There were negative correlation between NRS 2002 and BMI/TSF/AC/AMC （P 〈 0.05 ）. As the standard of serum albumin, the sensitivity of NRS 2002 was 95.3 % , specificity was 80.08% , positive predictive value was 74.3 %, and negative predictive value was 96.67 %. The ability of nutritional screening and nutritional assessment for the nurses was improving through training. Conclusion NRS 2002 is easy to master and has high sensitivity and specificity. It is recommend to be used as a screening tool for patients with radiotherapy. NRS2002 is easier for nurses to master by using CQI, causing thenutritional assessment and nursing intervention more efficiently.

关 键 词：NRS 2002 食管恶性肿瘤 放疗 营养筛查 

分 类 号：R473.73[医药卫生—护理学] R735.1[医药卫生—临床医学]