不同营养筛查方法在血吸虫性肝硬化患者的I隘床应用分析  

作　　者：王明友 俞进 胡震宇 李小兵 熊娇燕 朱红萍 

机构地区：[1]浙江省平湖市第一人民医院,314200

出　　处：《浙江临床医学》2018年第1期36-38,共3页Zhejiang Clinical Medical Journal

基　　金：浙江省医药卫生科技计划项目（2015KYB393）

摘　　要：目的采用不同营养筛查／评估方法对血吸虫性肝硬化患者的营养状况进行调查，筛选出适合该病患者的营养评价方法。方法选取2015年6月至2017年3月血吸虫性肝硬化患者106例，其中Child—PughA级28例、t3级30例、C^t48例。分别应用主观全面评估（SGA）、营养风险筛查2002（NRS2002）和皇家自由医院营养优先筛查模式工具（RFH—NPT）、人体组成评价法（BCA）对其进行营养风险筛查并比较。结果应用不同营养评估方法评估患者的营养状况时，除BMI、MAMC和LYM外，其他营养评估方法在肝功能分级不同组间差异均有统计学意义；在评估营养风险时，肝功能分级相同的组内有营养风险组和无营养风险组差异有统计学意义；SGA、NRS2002、RFH—NPT和ALB评估的患者营养风险发生率较高（〉49％），BMI和TSF评定的患者营养风险发生率较低（〈17％）。SGA、NS2002和RIZH～NPT对血吸虫性肝硬化患者的筛查结果显示：患者存在营养风险的比例分别为52例（49．1％），58例（54．7％），72例（67．9％）；此外，RFH—NPT与SGA及NRS2002比较，差异有统计学意义（P〈0．05），而SGA与NRS2002比较，差异无统计学意义（P〉0．05）。结论RFH～NPT更适合评估血吸虫性肝硬化患者的营养状况。Objective To investigate the nutrition status in patients with schistosomiasis cirrhosis by using different nutritional assessment methods and to find a suitable nutritional assessment method for schistosomiasis cirrhosis. Methods 106 cases of hospitalized patients with schistosomiasis cirrhosis were recruited in the study. Among them, there were 28 cases for Child-Pugh grade A, 30 cases for Child-Pugh grade B, and 48 cases for Child-Pugh grade C. Subjective Comprehensive Assessment （ SGA ） , Nutritional risk Screening 2002 （ NRS2002 ） , Royal Free Hospital-Nutritional Prioritizing Tool （ RFH-NPT ） , and Body Composition Assessment （BCA） were used to assess nutrition risk respectively. Results There were significant differences on evaluating patients＇ nutrition status using different nutritional assessment methods among the different fiver function classification groups （ except using BMI, MANIC, LYM ） . When evaluated nutritional risk, there was a significant difference between nutrition risk group and no nutrition risk group in the same liver function classification group, there was a higher rate of nutrition risk by using SGA, NRS2002, RFH - NPT and ALB to assess the patients＇ nutrition risk （〉49%） , but a lower rate by using BMI and TSF （〈17%） .Using SGA, NRS2002, RFH-NPT, the rates of malnutrition risk were 49.1%, 54.7%, 67.9%, respectively. The significant difference could be found （ P〈0.05 ） when compared RFH-NPT with SGA and NRS2002.There was no statistical significance between SGA and NRS2002. Conclusion RFH-NPT is more suitable to assess nutritional status for patients with schistosomiasis cirrhosis.

关 键 词：血吸虫性肝硬化 营养评估方法 营养筛查 营养风险 

分 类 号：R575.2[医药卫生—消化系统]