酒精依赖病人营养风险筛查及对医院感染的影响  

Nutrition risk screening in patients with alcohol dependence and its effects on nosocomial infection

作　　者：宋志领[1] 李增宁 李康宁[1] 于鲁璐[1] 王巍[1] SONG Zhi-ling;LI Zeng-ning;LI Kang-ning;YU Lu-lu;WANG Wei(Shijiazhuang 050031,Hebei,China)

机构地区：[1]河北医科大学第一医院精神卫生研究所

出　　处：《肠外与肠内营养》2019年第3期170-173,共4页Parenteral & Enteral Nutrition

摘　　要：目的:调查酒精依赖病人营养风险,分析营养风险对酒精依赖病人医院感染的影响。方法:选取住院戒酒的酒精依赖病人 245例,使用营养风险筛查量表(NRS 2002),对病人进行营养评估,将病人分为研究组(NRS≥3,n=92)和对照组(NRS<3,n=153),观察两组病人医院感染率。结果:研究组发生医院感染 34 例,发生率36.96%;对照组发生医院感染 28例,发生率 18.30%。两组病人的医院感染率差异有统计学意义(P=0.01)。感染部位分布,两组病人均以胃肠道和上呼吸道感染为主,感染率分别为 16.30%、13.04%和 9.15%、6.54%。研究组病人红细胞(P=0.034)、血红蛋白(P<0.001)、白蛋白(P<0.001)和 BMI水平(P<0.001)低于对照组病人,差异均有统计学意义;多因素 Logistic回归分析显示,NRS 2002评分增加(OR=1.391,P=0.032)、白蛋白降低(OR=0.923,P=0.031)、血红蛋白降低(OR=0.979,P=0.018)和吸烟(OR=1.063,P=0.007)是酒精依赖病人发生医院感染的危险因素。结论:酒精依赖病人更易发生营养风险,且存在营养风险的酒精依赖病人医院感染发生率显著增高。医院感染部位分布显示,两组酒精依赖病人均以胃肠道和上呼吸道感染为主。NRS 2002评分增加、白蛋白降低、血红蛋白降低以及吸烟量增加是酒精依赖病人发生医院感染的危险因素,临床医师应加强对有营养风险的酒精依赖病人的关注,加强营养支持,预防医院感染。Objective: To investigate the nutrition risk in patients with alcohol dependence and its effects on nosocomial infection. Methods: Two hundred and forty-five hospitalized patients with alcohol dependence at admission were included. Nutrition risk screening 2002 (NRS 2002) was used to evaluate the nutrition risk of these patients. They were assigned to the study group (NRS≥3,n=92) and the control group(NRS<3,n=153) according to the NRS 2002 score, and the nosocomial infection rates were recorded and analyzed. Results: In the study group, nosocomial infection occurred in 34 cases,with an incidence rate of 36.96%. In comparison, 28 cases in the control group had nosocomial infection,with an incidence rate of 18.30%, which was significantly lower than that in the study group (P=0.01). Gastrointestinal tract and upper respiratory tract infections were the most common types both in the two groups,with incidence rates of 16.30%,9.15% in the study group and 13.04%, 6.54% in the control group, respectively.In addition,the red blood cells count (P=0.034),the serum levels of hemoglobin(P<0.001) and albumin(P<0.001),and body mass index (BMI)(P<0.001) in the study group were significantly lower than these in the control group. Multivariate Logistic regression analysis showed that increased NRS2002 score(OR=1.391,P=0.032),decreased albumin levels (OR=0.923,P=0.031),decreased hemoglobin levels (OR=0.979,P=0.018) and smoking(OR=1.063,P=0.007) were independent risk factors for nosocomial infection in patients with alcohol dependence. Conclusion: Patients with alcohol dependence are more likely to have nutrition risk, and the incidence of nosocomial infection in alcohol-dependent patients with high nutritional risk significantly increases. Gastrointestinal tract and upper respiratory tract were the most common infection sites in patients with alcohol dependence. Increased NRS 2002 score, decreased albumin levels, decreased hemoglobin levels, and smoking were risk factors for nosocomial infection in alcoholdependent patients. Hen

关 键 词：酒精依赖 营养风险筛查量表 医院感染 胃肠道感染 

分 类 号：R749[医药卫生—神经病学与精神病学]