中国住院病人营养不良及住院时间延长的危险因素分析  

Analysis of risk factors for malnutrition and length of stay in Chinese hospitalized patients

作　　者：张玉鹏 章黎 黄迎春 周伟[2] 杨晓燕[2] 崔瑶 赵恒芳 聂俊英[5] 董素萍 卞晓洁[6] 邓桂芳 徐洁莲 刘小孙[9] 董洋 张晓岚[10] 宋佳[10] 陈莲珍 吴健雄 王新颖 ZHANG Yu-peng;ZHANG Li;HUANG Ying-chun;ZHOU Wei;YANG Xiao-yan;CUI Yao;ZHAO Heng-fang;NIE Jun-ying;DONG Su-ping;BIAN Xiao-jie;DENG Gui-fang;XU Jielian;LIU Xiao-sun;DONG Yang;ZHANG Xiao-lan;SONG Jia;CHEN Lian-zhen;WU Jianxiong;WANG Xin-ying(Department of General Surgery,Jinling Hospital,Medical School of Nanjing University,Nanjing 210002,Jiangsu,China;Department of General Surgery,Sir Run Run Shaw Hospital,School of Medicine,Zhejiang University,Hangzhou 310016,Zhejiang,China;Pizhou Hospital Affiliated to Xuzhou Medical University,Pizhou 221300,Jiangsu,China;Department of Gastroenterology,Xi`an No.3 Hospital,the Affiliated Hospital of Northwest University,Xi`an 710018,Shanxi,China;The affiliated hospital of Inner Mongolia medical university,Huhehaote 010050,Neimenggu,China;Department of Pharmacy,Nanjing Drum Tower Hospital,The Affiliated Hospital of Nanjing University Medical School,Nanjing 210008,Jiangsu,China;Department of Clinical Nutrition,Huazhong University of Science and Technology Union Shenzhen Hospital,Shenzhen 518052,Guangdong,China;The Affiliated Jiangning Hospital of Nanjing Medical University,Nanjing 211100,Jiangsu,China;The First Affiliated Hospital,Zhejiang University,Hangzhou 310003,Zhejiang,China;The Second Hospital of Hebei Medical University,Shijiazhuang 050035,Hebei,China;National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital,Chinese Academy of Medical Sciences and Peking Union Medical College,Beijing 100021,China)

机构地区：[1]南京大学医学院附属金陵医院普通外科,江苏南京210002 [2]浙江大学医学院附属邵逸夫医院普外科,浙江杭州310016 [3]徐州医科大学附属邳州医院,江苏邳州221300 [4]西北大学附属医院·西安市第三医院消化科,陕西西安710018 [5]内蒙古医科大学附属医院,内蒙古呼和浩特010050 [6]南京大学医学院附属鼓楼医院药学部,江苏南京210008 [7]华中科技大学协和深圳医院临床营养科,广东深圳518052 [8]南京医科大学附属江宁医院,江苏南京211100 [9]浙江大学附属第一医院,浙江杭州310003 [10]河北医科大学第二医院,河北石家庄050035 [11]国家癌症中心/国家肿瘤临床医学中心/中国医学科学院北京协和医学院肿瘤医院,北京100021

出　　处：《肠外与肠内营养》2020年第3期136-142,共7页Parenteral & Enteral Nutrition

摘　　要：目的:调查中国住院病人营养状况,探索发生营养不良及影响住院时间(LOS)的危险因素。方法:通过参加“世界营养日”活动,以问卷形式收集2018年11月15日全国11家医院住院病人的营养相关状况,30 d后随访病人临床结局。结果:我国住院病人营养不良及营养风险发生率分别为11.6%、20.7%。存在营养不良/营养风险者有59.7%获得营养干预,而营养良好者仅21.9%获得营养干预。曾入住ICU的病人营养不良/营养风险发生率53.4%,LOS 15.5(10.0~26.0)d均显著高于未曾入住ICU者30.6%,LOS 10.0(6.0~16.0)d,P<0.001。曾入住ICU、住院期间计划手术、活动力差、入院前1周饮食量减少、近3月体质量下降是营养不良/营养风险的危险因素;男性、营养状况差、住院期间行手术治疗、曾入住ICU、调查当天饮食量减少、近3月体质量下降是LOS延长的危险因素。结论:我国住院病人营养不良/营养风险的发生率较高,但国内营养支持治疗逐年规范。曾入住ICU、饮食量减少、近3月体质量下降是营养不良/营养风险及病人住院时间延长的危险因素。Objective:To investigate the nutritional status in Chinese hospitalized patients and to explore risk factors for malnutrition and length of hospital stay.Method:The basic information and nutrition status of the hospitalized patients in 11 hospitals were collected through“NutritionDay worldwide”questionnaires on November 15,2018.Clinical outcomes were followed up 30 days later.Result:The incidence of malnutrition and the nutritional risk was 11.6%and 20.7%,respectively.Among patients diagnosed with malnutrition or at nutritional risk,59.7%received nutritional support therapy,while only 21.9%of well-nourished patients received the nutritional intervention.The incidence of malnutrition and nutritional risk in patients who had been admitted in ICU was 53.4%,the LOS was 15.5(10.0~26.0)d,and it was 10.0(6.0~16.0)d in patients who had not been admitted in ICU,the incidence was 30.6%,P<0.001.Previously admitted to the ICU,planned surgery during hospitalization,poor mobility,decreased diet 1 week before admission,and weight loss in recent 3 months were the risk factors of malnutrition and nutritional risk.Besides,male,poor nutritional status,operation during the stay,previously admitted to the ICU,decreased diet on the NutritionDay,and weight loss in recent 3 months were the risk factors for prolonged LOS.Conclusion:In China,the incidence of malnutrition and nutritional risk in hospitalized patients is high,however,nutritional support therapy has been standardized year by year.Admission to the ICU during hospitalization,changes in dietary status,and weight loss in recent 3 months are risk factors for malnutrition/nutritional risk and could prolong the LOS.

关 键 词：住院病人 世界营养日 营养不良 营养支持治疗 住院时间 

分 类 号：R473.5[医药卫生—护理学]