营养风险筛查(NRS 2002-01.017)、营养不良诊断(GLIM-表现型指标01.028、病因型指标01.029)  

Terminology interpretation of nutritional risk screening(NRS 2002-01.017)and malnutrition diagnosis(GLIM-phenotypic criteria 01.028,etiologic criteria 01.029)

作　　者：岳向峰 张献娜 王雨 康维明[3] 路潜[4] 杨剑 叶欣[3] 许红霞 潘宏铭[7] 许静涌[8] 蒋朱明[3] Yue Xiangfeng;Zhang Xianna;Wang Yu;Kang Weiming;Lu Qian;Yang Jian;Ye Xin;Xu Hongxia;Pan Hongming;Xu Jingyong;Jiang Zhuming(Department of Pharmacy,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China;Department of Pancreatic Surgery,Wuhan Union Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430030,China;Departments of General Surgery,Peking Union Medical College Hospital,Peking Union Medical College,Chinese Academy of Medical Sciences,Beijing 100730,China;Division of Medical&Surgical Nursing,School of Nursing,Peking University,Beijing 100191,China;Department of Clinical Nutrition,the Third Affiliated Hospital of Chongqing Medical University,Chongqing 401120,China;Clinical Nutrition Department of Army Characteristic Medical Center,Chongqing 400042,China;Department of Oncology,Run Run Shaw Hospital,School of Medicine of Zhejiang University,Hangzhou 310016,China;Department of General Surgery,Beijing Hospital,National Center of Gerontology,Beijing 100730,China)

机构地区：[1]郑州大学第一附属医院药学部,450052 [2]华中科技大学,同济医学院附属协和医院胰腺外科,武汉430022 [3]北京协和医学院,北京协和医院基本外科,100730 [4]北京大学护理学院内外科护理学教研室,100191 [5]重庆医科大学附属第三医院临床营养科,401120 [6]陆军特色医学中心临床营养科,重庆400042 [7]浙江大学邵逸夫医院肿瘤内科,杭州310020 [8]北京医院国家老年医学中心普通外科,100730

出　　处：《中华临床营养杂志》2021年第2期123-128,共6页Chinese Journal of Clinical Nutrition

摘　　要：NRS2002工具创始人Kondrup和Rasmussen在中华医学会肠外肠内营养学分会营养风险-不足-支持-结局-成本/效果多中心分享数据库协作组第42次、44次工作坊的报告中分别对NRS 2002工具的应用内涵和NRS 2002工具形成的循证基础及前瞻性临床有效性验证的方法学做了阐述,也对NRS 2002中营养受损部分达到3分可以用来评定营养不良做了说明。该营养不良评定方法虽简便易行,但不够全面,无法用于营养不良诊断。为解决营养不良诊断的一致性问题,2018年9月,美国肠外肠内营养学会与欧洲临床营养和代谢学会网站在线发表了由全球四大肠外肠内营养学会共同完成的全球(营养)领导层倡议营养不良诊断(Global Leadership Initiative on Malnutrition,GLIM)标准。随着我国依据疾病诊断相关分组支付医保费用的推行,应该在住院病案首页填写有中国版ICD-10(2016)代码的营养风险和营养不良的疾病名称。基于此,本文结合Kondrup和Rasmussen在北京和郑州的报告内容对《肠外肠内营养学名词-2019》中的营养风险筛查(NRS 2002)、营养不良诊断(GLIM)名词进行第一阶段解读。In the 42^(nd) and 44^(th) workshops of CSPEN-nutritional risk-undernutrition-support-outcome-cost effectiveness ratio(NUSOC)multi-center database collaboration group,Jens Kondrup and Henrik Rasmussen described again the application of NRS 2002,the evidence-based basis of NRS 2002 development and the methodology for prospective validation of clinical effectiveness.There is no gold standard for validation.They both considered that malnutrition could be identified as a score of 3 or more for impaired nutritional status in NRS 2002.Although NRS 2002 is simple and easy to be applied,it is not comprehensive enough for malnutrition diagnosis.ASPEN and ESPEN on-line published the Global Leadership(nutritional)Initiative on Malnutrition(GLIM)diagnosis criteria in September 2018.With the gradual implementation of medicare payment based on diagnosis related groups(DRG)in China,the nutritional risk and the malnutrition diagnosis with Chinese version of ICD-10(2016)code should be recorded in the first page of the medical records.In this terminology interpretations,the terms of nutritional risk screening(NRS 2002.01.016)and malnutrition diagnosis(GLIM-phenotypic criteria 01.028,etiologic criteria 01.029)published in Parenteral and Enteral Nutrition Terminology 2019 are discussed based on the reports given by Kondrup and Rasmussen in Beijing and Zhengzhou.

关 键 词：营养风险 营养风险筛查2002 营养不良 营养不良诊断 全球(营养)领导层倡议营养不良诊断标准(GLIM) 

分 类 号：R459.3[医药卫生—治疗学]