宁波某三甲医院用NRS 2002和营养不良诊断(GLIM)标准对老年压疮患者的营养风险和营养不良患病率调查研究  

Investigation on nutritional risk and malnutrition prevalence of elderly patients with pressure ulcer using NRS 2002 and GLIN criteria a tertiary(A)hospital in Ningbo

作　　者：谢浩芬[1] 徐琴鸿[1] 陈巧女[2] 蔡泽君 李益萍[2] 徐佳荣 姜建帅[2] 蒋朱明[3] 潘宏铭[4] Xie Haofen;Xu Qinhong;Chen Qiaonv;Cai Zejun;Li Yiping;Xu Jiarong;Jiang Jianshuai;Jiang Zhuming;Pan Hongming(Department of Nursing,Ningbo First Hospital,Ningbo 315010,China;Department of Surgery,Ningbo First Hospital,Ningbo 315010,China;Department of General Surgery,Peking Union Medical College Hospital,Beijing 100730,China;Department of Oncology,Affiliated to Zhejiang University School of Medicine,Hangzhou 310016,China)

机构地区：[1]宁波市第一医院护理部,315010 [2]宁波市第一医院外科,315010 [3]中国医学科学院北京协和医学院北京协和医院基本外科,100730 [4]浙江大学医学院附属邵逸夫医院肿瘤内科,杭州310016

出　　处：《中华临床营养杂志》2020年第4期214-219,共6页Chinese Journal of Clinical Nutrition

基　　金：宁波市医学科技计划项目(2011A03);浙江省医学科技计划项目(2017KY587)。

摘　　要：目的应用全球营养领导人发起的营养诊断(共识)对老年压疮患者营养风险、营养不良患病率。方法按整群采样,以老年压疮为入组对象的横断面调查研究。对2019年1—12月宁波市第一医院神经内科病区、骨科病区、化放疗病区、老年医学病区的老年压疮患者进行筛查。用营养风险筛查2002评分(NRS 2002)工具调查营养风险患病率。营养不良患病率分为以下来源:(1)体重指数(body mass index,BMI)<18.5 kg/m^2伴一般情况差(简称BMI标准);(2)NRS 2002达到3分(简称NRS 2002标准)评定为营养不良;(3)采用全球(营养)领导人对营养不良标准(GLIM)的第二步流程(不包括全身肌肉量测定)(简称GLIM标准)诊断营养不良。结果按整群采样四个病区共计6735例住院患者,老年住院患者占52.13%(3511例),经入排标准核查,302例老年压疮患者入组,老年压疮的发生率为8.60%。老年压疮患者的营养风险患病率53.64%(162/302例);依据BMI标准、NRS 2002标准及采用GLIM标准诊断营养不良患病率分别为23.51%、28.48%、24.83%。结论老年压疮患者的营养风险患病率比较高,GLIM营养不良与NRS 2002量表中的营养缺失,体重指数<18.5 kg/m^2伴一般情况差作为参比。Objective Evaluation of nutritional risk and prevalence of malnutrition in elderly patients with pressure sores using malnutrition diagnosis(consensus)initiated by global nutrition leaders.Methods Cluster sampling was adopted to conduct the cross-sectional survey in elderly patients with pressure sore hospitalized in Ningbo First Hospital from January,2019 to December,2019.Patients from Departments of Neurology,Orthopedics,Chemo-radiotherapy and Geriatric medicine were enrolled.NRS 2002 was applied to screen the nutritional risk.Malnutrition was determined with 3 methods:1)body mass index(BMI)<18.5 kg/m^2 complicated with poor general condition;2)assessed as malnutrition with the score of 3 for the impaired nutrition status in NRS 2002;3)diagnosed with malnutrition as per the second step of Global Leadership Initiative on Malnutrition(GLIM)criteria(excluding the measurement of total body muscle mass).Results A total of 6735 patients from 4 departments were screened,among whom 52.13%(3511)were elderly.302 elderly patients with pressure ulcers were eligible for enrollment according to the inclusion and exclusion criteria.The prevalence of nutritional risk of elderly patients with pressure sore was 53.64%(162/302).The prevalence of malnutrition was 23.51%,28.48%and 24.83%as per the criteria of BMI<18.5 kg/m^2 complicated with poor general conditions,scored 3 for impaired nutrition status in NRS 2002 and the second step of GLIM criteria,respectively.Conclusions The prevalence of nutritional risk was higher in elderly patients with pressure ulcer.GLIM malnutrition was compared with the nutritional deficiency in NRS 2002 scale,BMI<18.5 kg/m^2 and general condition difference.

关 键 词：压疮 营养不良 患病率 

分 类 号：R632.1[医药卫生—外科学]