两种营养筛查方法在神经内科老年住院患者中的应用  

Application of Two kinds of Nutritional Screening Methods in Elderly Patients with Neurology

作　　者：毕研霞[1] 洪忠新[1] 张立红[1] 李伟[1] 顾中一[1] 葛智文[1] 

机构地区：[1]首都医科大学附属北京友谊医院营养科,北京100050

出　　处：《中国食物与营养》2017年第3期76-80,共5页Food and Nutrition in China

摘　　要：目的:用营养风险筛查2002和微型营养评价精法评价神经内科老年住院患者的营养状况,分析不同因素对其营养状况的影响,比较2种营养筛查方法的适用性和结果,为临床营养筛查提供科学依据。方法:选择2014年5月—2015年4月入住北京友谊医院神经内科的年龄≥65岁、住院时间≥24h的180例老年患者,由经过培训的营养师对神经内科的老年住院患者用营养风险筛查2002(NRS2002)和微型营养评价精法(MNASF)2种筛查方法进行营养风险评估,观察其评估营养状况的可行性。结果:180例老年患者中低体重、超重和肥胖发生率分别为6.1%、23.3%和16.7%,体重指数正常者占53.9%。采用NRS2002对患者进行营养风险评定,有营养风险者共计75例(41.7%),其中男性患者61例占42.7%、女性患者14例占37.8%;高年龄组患者有营养风险的比例较高(59.4%)。采用MNA-SF进行营养风险筛查,营养不良风险的发生率为58.3%、营养不良的发生率为17.3%,随着年龄的增长,营养不良的发生率增加(P<0.05)。105例NRS<3分的患者,再按照MNA-SF进行评价,有营养不良风险的65例(61.9%)、营养不良者6例(5.7%);NRS≥3分者75例,再按照MNA-SF进行评价,有营养不良风险的共40例(53.3%)、营养不良者25例(33.3%),2种方法的筛查结果差异有统计学意义,MNA-SF的营养风险检出率更高。结论:MNA-SF的适用性更好,老年患者存在较高的营养不良风险发生率,营养技师应加强对患者进行营养宣教,配合临床医生积极进行营养干预和营养治疗,改善患者的营养状况。[Objective] To evaluat the nutritional status of hospitalized patients with geriatric neurology by using NRS2002 and MNA-SF and compare the applicability and results of two methods to provide the scientific basis for nutrition risk screening. [Method] Totally 180 cases with geriatric neurology were randomly selected as the research subjects from May 2014 to April 2015, age 65 or higher, the length of time of 24 h. The dietitian evaluated nutritional status of the patients by NRS2002 and MNA-SF and explore its application feasibility. [Result] Totally 180 elderly patients with low weight, overweight and obesity rates were 6. 1% , 23.3% and 16. 7% , normal body mass in- dex （BMI） accounted for 53.9%. Evaluation of the nutritional status by NRS2002, 75 cases had malnutrition, the incidence of malnutrition risk was 41.7%. Risk of malnutrition in male patients was 42. 7% , and female patients accounted for 37.8%. The incidence of malnutrition in patients with different age was statistically significant （ P 〈 0.05 ） , high age group of patients with malnutrition risk had higher percentage （59.4%） . There was no statistically significant difference in nutritional risk of male and female patients by MNA-SF （ P 〉 0. 05 ） . The in- cidence of the risk of malnutrition was 58.3% , the incidence of malnutrition was 17. 3%. Along with the growth of the age, the incidence of malnutrition improved （P 〈0. 05） . According to MNA-SF evaluation, patients of 105 cases of NRS 〈3 points, 65 cases （61.9%） had the risk of malnutrition, 6 eases （5.7%） had malnutrition, 75 cases of NRS score 3 or higher, then according to the MNA-SF evaluation, normal nutrition of 10 cases （ 13. 3% ）, the risk of malnutrition of 40 eases （53.3%）, and malnutrition of 25 eases （33.3%） . The results of two methods was statistically significant, the detection rate was higher. [Conclusion] MNA-SF had better applicability, we should strengthen their nutritional education and periodically evaluate their nutritional

关 键 词：营养风险筛查2002 微型营养评价精法 老年 营养风险 营养不良 营养不良风险 

分 类 号：R459.3[医药卫生—治疗学]