昆明地区某三甲医院普通外科住院手术患者营养情况调查  

Nutritional risks,undernutrition and nutrition support among inpatients who accepted general procedures in a tertiary hospital in Kunming

作　　者：孙大力[1] 徐鹏远[1] 岑云云[1] 陈雄志[1] 林岳瀛 李为明[1] 戚宇星[1] 许青文[1] 李树民[1] 李奕俊[1] 孙岩波[1] 杨婷[1] 

机构地区：[1]昆明医科大学第二附属医院胃肠外科二病区/云南省外科临床营养研究中心,昆明650101

出　　处：《重庆医学》2016年第34期4830-4833,共4页Chongqing medicine

基　　金：国家自然科学基金资助项目(81160114);云南省外科临床营养研究中心基金项目(2014NS090)

摘　　要：目的调查普通外科住院手术患者入院时营养风险、不足和住院期间营养支持情况。方法采用定点连续抽样方法,对2010年1月至2011年11月在该院普通外科住院手术患者应用营养风险筛查2002(NRS2002)进行营养风险筛查,并调查住院期间营养支持情况。结果在调查期间,有15 563例住院患者,其中13 935例患者进行了营养风险筛查,排除非手术患者4348例,最终可供分析病例为9 587例。营养不足和营养风险的总发生率分别为7.4%和18.7%。各病种中,胃肠恶性疾病营养不足和营养风险发生率最高,分别为40.0%和53.2%。在普通外科住院手术患者中,营养支持的比例为8.7%,其中肠外营养(PN)为4.8%,PN+肠内营养(EN)为2.9%,EN仅为1.0%;营养素应用不足占85.4%;营养素应用严重不足占4.1%;无营养支持占1.8%。在NRS≥3分的患者中,接受营养支持的患者占38.9%,营养素应用不足的患者占57.9%,营养素应用严重不足和无营养支持的患者占3.2%。结论胃肠恶性疾病患者营养不足和营养风险发生率最高;营养素应用不足在普通外科住院手术患者中较为普遍;对有营养风险的普外住院手术患者进行营养支持比例较低,需要进一步规范。Objective To investigate the nutritional risks,undernutrition and nutrition support among inpatients who accepted general procedures. Meibods The nutrition risk of inpatients who accepted general procedures in the department of general surgery in the second affiliated hospital of Kunming medical university were consecutively assessed using Nutrition risk screening 2002 （NRS 2002） and recorded from January 2010 to November 2011. Nutrition support was evaluated until the discharge. Results Among 15 563 inpatients, 13 935 inpatients accepted nutrition risk screening, 4 348 inpatients without accepting general surgery were excluded,finally,9 587 inpatients were enrolled. Among them, the undernutrition rate and at-risk rate were 7.4% and 18.7% respectively. The highest undernutrition rate and at-risk rate appeared in patients who suffered the gastrointestinal malignant diseases （40.0%＆ 53.2%）. 8.7% patients received nutrition support（including 4.8% PN,2.9% PN＋EN and 1.0% EN） ,the other patients accepted inadequate nutrient application（85.4 % ）, extremely inadequate nutrient application（4.1% ） and no support（1.8 % ）. Among at-risk （NRS^3） patients,38.9% patients received nutrition support, 57.9% patients accepted inadequate nutrient application,3.2% patients applied extremely inadequate nutrient application and no support. Conclusion The undernutrition rate and at- risk rate among inpatients who accepted general procedures are 7.4 % and 18.7 % respectively,the highest undernutrition rate and at-risk rate appear in patients who suffer the gastrointestinal malignant diseases. Inadequate nutrient application is prevalent in inpatients who accepted general procedures in general surgery department. Meanwhile,there is a lower rate of nutrition support among the at-risk patients,and the application of nutrients should be further standardized.

关 键 词：营养调查 营养支持 营养不良 胃肠外营养 营养风险筛查2002(NRS2002) 

分 类 号：R619[医药卫生—外科学] R459.3[医药卫生—临床医学]