手术患者营养风险筛查及营养支持与术后并发症和住院时间的相关性  

Association of nutritional risk screening and nutritional support with postoperative complications and length of hospital stay in surgery patients

作　　者：周锦[1] 曹雯雯[2] 石军梅[3] 马玉霞[1] 包士峰[1] 丁树荣[1] 曹丹丹[1] 

机构地区：[1]河北医科大学公共卫生学院,石家庄050017 [2]河北医科大学第二医院消化科,石家庄050005 [3]河北医科大学第四医院肿瘤科,石家庄050011

出　　处：《中华临床营养杂志》2015年第6期368-372,共5页Chinese Journal of Clinical Nutrition

摘　　要：目的分析普通外科手术住院患者的营养风险及营养支持情况，并探讨两者与患者术后并发症以及住院时间的相关性。方法选取2014年1月至2015年2月河北医科大学第二医院853例普通外科住院患者为研究对象，采用营养风险筛查2002（NRS2002）进行营养情况调查。根据患者是、否接受营养支持分成两组。记录患者的住院天数以及术后并发症，分析患者营养风险以及营养支持对并发症和住院时间的影响。结果853例普通外科住院患者中，营养风险和营养不良发生率分别为31．1％（265／853）和5．4％（46／853）。术后并发症发生率为14．2％（121／853），营养风险患者比无营养风险患者更容易出现术后并发症[29．8％（79／265）比7．1％（42／588），P〈0．000]，并且住院时间更长[（12．5±6．4）d比（4．2±3．9）d，P〈0．001]。853例患者中，营养支持率为27．3％（233／853）。存在营养风险的患者中，营养支持组的患者并发症发生率显著低于无营养支持组的患者[16．7％（32／192）比64．4％（47／73），P〈0．05]，且住院天数更短[（7．5±4．6）d比（16．3±8．5）d，P〈0．05]。结论通过NRS2002营养风险筛查，发现一定量的普通外科手术患者存在较高的营养风险。体质量降低、饮食摄入量减少以及年龄大的患者处于营养风险的可能性更高。存在营养风险的患者更容易出现术后并发症和住院时间延长，营养风险患者更易从营养支持中受益。Objective To investigate the status of nutritional risk and nutritional support in general surgery patients, and to explore their association with postoperative complications and length of hospital stay. Methods From January 2014 to February 2015, 853 inpatients in general surgical wards in the Second Hos- pital of Hebei Medical University were enrolled. Nutritional Risk Screening 2002 （ NRS 2002 ） was used to estimate nutritional status of patients. The patients were divided into 2 groups based on whether they received nutritional support. The length of hospital stay in days and postoperative complications were recorded. The as- sociation of nutritional risk and nutritional support with complications and length of hospital stay were ana- lyzed. Results In the 853 surgery patients, the prevalence of nutritional risk was 31.1% （265/853） and that of malnutrition was 5.4% （46/853）. The incidence of postoperative complications was 14.2% （ 121/ 853 ）. The patients with nutritional risk had a significantly higher incidence of postoperative complications compared to those without nutritional risk E 29.8% （79/265） vs. 7.1% （42/588）, P 〈 0. 000 ], and a longer hospital stay [ （ 12.5 ±6.4） days vs. （4.2±3.9） days, P 〈0. 001 ]. In the 853 patients, 27.3% （233/853） received nutrition support. In the patients with nutritional risk, those on nutritional support had asignificantly lower incidence of complications compared with those not on nutritional support [ 16.7% （ 32/ 192） vs. 64.4% （47/73）,P〈0.05] and shorter hospital stay [ （7.5±4.6） daysvs. （16.3±8.5） days, P 〈 0.05 ]. Conclusions According to NRS 2002 result, a fairly high percentage of general surgery patients may have nutritional risk. Patients with decreased body mass, less dietary intake, and at higher age may be more likely to have nutritional risk. Nutritional risk may be associated with a higher incidence of post- operative complications and longer hospital stay. Patients at nutritional risk appear

关 键 词：营养风险筛查 普通外科住院患者 营养支持 

分 类 号：R459.3[医药卫生—治疗学]