术前营养风险筛查及术后营养支持对普通外科手术患者术后临床结局的影响  

Influence of preoperative nutritional risk screening and postoperative nutritional support on clinical outcomes in patients received general surgery

作　　者：刘艳[1] 吕学英 李克[3] 黄恩民[4] LIU Yan;L Xue ying;LI Ke;HUANG En min(University of South China, Hengyang 421001, Hunan, China;Public Health Office, the Second People’s Hospital of Hengyang, Hengyang 421001, Hunan, China;Shantou University, Shantou 515063, Guangdong, China;Department of General Surgery, the Second Affiliated Hospital of Shantou University Medical College, Shantou 515063, Guangdong, China)

机构地区：[1]南华大学,衡阳421001 [2]衡阳市第二人民医院公共卫生办公室,衡阳421001 [3]汕头大学,汕头515063 [4]汕头大学第二附属医院普通外科,汕头515063

出　　处：《中国临床医学》2017年第5期770-773,共4页Chinese Journal of Clinical Medicine

摘　　要：目的:应用营养风险筛查工具NRS 2002对住院患者开展术前营养风险筛查,了解其营养风险状况,并探讨术后营养支持情况与相关临床结局的关系。方法:选择在汕头大学第二附属医院普通外科三病区住院并于入院48h内完成NRS2002评分患者(378例)作为研究对象。评分≥3分者判定为有营养风险。将最终纳入队列研究的174例营养风险患者按是否接受营养支持分为营养支持组(114例)和非营养支持组(60例)。根据医嘱信息获得营养支持相关数据,每周2次记录住院患者相关临床结局,分析两者的关系。分析影响住院费用、感染性并发症发生率的因素。结果:378例住院患者中,营养风险率50.53%(191/378)。174例纳入队列研究住院患者中,营养支持率65.52%(114/174)。营养支持组与非营养支持组住院时间差异有统计学意义(P=0.028),两组住院费用差异无统计学意义。营养支持组感染性并发症发生率(P=0.034)、总并发症发生率(P=0.012)均低于非营养支持组。疾病评分、营养支持是感染性并发症发生率的影响因素(P<0.10)。住院天数、疾病评分、营养评分是住院费用的影响因素(P<0.10)。结论:普通外科患者营养风险率较高;NRS 2002对普通外科存在营养风险的患者的临床结局有一定预测功能;营养支持可减少感染性并发症、总并发症发生,缩短住院时间。Objective:To carry out preoperative nutritional risk screening for inpatient to understand their nutritional risk status,and to explore the relationship between postoperative nutritional support and related clinical outcomes.Methods:A total of378patients in the Third Ward of Department of General Surgery,the Second Affiliated Hospital of Shantou University,completed NRS2002scoring within48h after admission.The patients with NRS scores more than3points were judged to have nutritional risk,and they were divided into nutrition support group(114cases)and non nutrition support group(60cases)according to whether or not to accept the nutrition support.According to the doctor’s advice,the data of nutrition support were obtained,the related clinical outcomes were recorded twice a week,and the relationship between them was analyzed.The influencing factors of hospitalization costs and infectious complications were analyzed.Results:Among the378inpatients,the nutritional risk rate was50.53%.Of the174patients enrolled in the cohort study,the nutritional support rate was65.52%(114/174).The difference of hospitalization time between the nutrition support group and the non nutrition support group was statistically significant(P=0.028).There was no significant difference between the two groups in the hospitalization costs.The incidence of infectious complications(P=0.034)and the total complication rate(P=0.012)in the nutrition support group were lower than those in the non nutrition support group.Disease score and nutrition support were the influencing factors of the incidence of infectious complications(P<0.10).Hospitalization days,disease score and nutrition score were the influencing factors of hospitalization costs(P<0.10).Conclusions:General surgery patients have higher nutrition risks,and nutrition support can reduce infectious complications,total complications and shorten hospital stay.NRS2002has a superior ability of predicting clinical outcomes.

关 键 词：营养风险筛查 营养支持 普通外科 临床结局 

分 类 号：R619[医药卫生—外科学]