长沙某三甲医院消化道终末期癌症住院患者营养风险、营养不良(GLIM)患病率横断面调查  

A cross-sectional survey on nutritional risk and prevalence of malnutrition per Global Leadership Initiative on Malnutrition criteria in patients with end-stage malignant gastrointestinal tumors in a tertiary(A)hospital in Changsha

作　　者：曾敏婕[1] 张梦游 刘敏[2] 张渝[1] 万欢[3] 陈晨[3] 谢燕平[4] 汤珂[1] 刘展[1] 严柳青[1] 顾晗 张献娜 蒋朱明[6] Zeng Minjie;Zhang Mengyou;Liu Ming;Zhang Yu;Wan Huan;Chen Chen;Xie Yanping;Tang Ke;Liu Zhan;Yan Liuqing;Gu Han;Zhang Xianna;Jiang Zhuming(Department of Digestion and Nutrition,Hunan Provincial People's Hospital(the First Affiliated Hospital of Hunan Normal University),Changsha 410004,China;Department of Nutrition,The ThirdXiangya Hospital,Central South University,Changsha 410007,China;Department of HepatobiliarySurgery,Hunan Provincial People's Hospital,Changsha 410004,China;Department of Nutrition,Hunan Cancer Hospital,Changsha 410007,China;Department of Pancreatic Surgery,Union HospitalAffiliated to Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430022,China;Department of General Surgery,Peking Union Medical College Hospital,Peking Union Medicalcollege,Chinese Academy of Medical Sciences,Beijing 100730,China)

机构地区：[1]湖南省人民医院(湖南师范大学附属第一医院)消化营养科,长沙410004 [2]中南大学湘雅三医院营养科,长沙410007 [3]湖南省人民医院肝胆外科,长沙410004 [4]湖南省肿瘤医院营养科,长沙410007 [5]华中科技大学同济医学院附属协和医院胰腺外科,武汉430022 [6]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

出　　处：《中华临床营养杂志》2021年第5期275-280,共6页Chinese Journal of Clinical Nutrition

基　　金：长沙市科学技术局(kq1901055)。

摘　　要：目的调查长沙某三甲医院消化道终末期癌症住院患者营养风险及营养不良患病率。方法采用整群抽样,对2019年1月至2020年7月湖南省人民医院消化内科、胃肠外科、肝胆外科、肿瘤科住院患者进行横断面调查研究,用营养风险筛查(nutritional sisk screening 2002,NRS 2002)分析营养风险患病率,用体重指数<18.5 kg/m^(2)且一般情况差,以及NRS 2002营养状况受损评分3分评定营养不良;全球(营养)领导层倡议营养不良诊断标准(global leadership initiative on malnutrition,GLIM)第2步(不包括全身肌肉量)诊断营养不良,用GLIM第3步诊断严重营养不良现患率。结果按整群采样4个科室共计802例患者登记在案,经入排标准核查,514例患者入组。消化道终末期癌症住院患者营养风险现患率为49.8%;GLIM营养不良患病率及严重营养不良患病率分别为41.6%和18.3%。结论虽然按国内国际指南/共识终末期癌症患者一般不推荐为营养支持疗法的适应证,本文是横断面调查研究消化道终末期癌症住院患者的营养风险和营养不良的客观患病率,观察到并没有如某些文章中描述的那么高。Objective To investigate the nutritional risk and prevalence of malnutrition in patients with terminal stage gastrointestinal malignant tumors in a tertiary hospital in Changsha.Methods Cluster sampling was used to conduct a cross-sectional survey of inpatients from Departments of Gastroenterology,Gastrointestinal Surgery,Hepatobiliary Surgery and Oncology in Hunan Provincial People's Hospital from January 2019 to July 2020.Nutritional Risk Screening 2002(NRS 2002)was used to assess the prevalence of nutritional risk with malnutrition defined as concurrent presence of BMI<18.5 kg/m^(2),poor general condition and NRS 2002 nutritional impairment score of 3.Step 2 of Global Leadership Initiative on Malnutrition(GLIM)diagnostic criteria(without whole body muscle mass)was adopted to diagnose malnutrition.Step 3 of GLIM criteria was used to evaluate the prevalence of severe malnutrition.Results A total of 802 patients registered in the 4 departments were selected for screening via cluster sampling and 514 were enrolled according to the inclusion/exclusion criteria.The prevalence of nutritional risk in patients with terminal stage gastrointestinal cancer was 49.8%(256/514).The prevalence of malnutrition and severe malnutrition per GLIM criteria were 41.6%(214/514)and 18.3%(94/514),respectively.Conclusions Although nutritional support therapy is not recommended for patients with end-stage cancer.This paper suggests that the prevalence of nutritional risk and malnutrition in patients with end-stage gastrointestinal cancer is not as high as described in some articles.

关 键 词：消化道终末期癌症 营养不良 

分 类 号：R735[医药卫生—肿瘤]