肝胆外科患者营养状态动态变化的前瞻性调查研究  

Dynamic change of nutritional risk in hepatological surgery patients during hospitalization:a prospective survey

作　　者：李磊[1] 杨鑫[1] 刘鹏[1] 李鹏雪 崔红元[1] 刘承宇 朱明炜[1] 韦军民[1] Li Lei;Yang Xin;Liu Peng;Li Pengxue;Cui Hongyuan;Liu chengyu;Zhu Mingwei;Wei Junmin(Department of General Surgery Department of Hepato-bilio-pancreatic surgery,National Center of Gerontology,Beijing Hospital,Institute of Geriatric Medicine,Chinese Academy of Medical Sciences,Beijing 100730,China)

机构地区：[1]北京医院普通外科,肝胆胰外科,国家老年医学中心,中国医学科学院老年医学研究院,100730

出　　处：《中华临床营养杂志》2021年第6期321-325,共5页Chinese Journal of Clinical Nutrition

基　　金：北京市科学技术委员会重点项目(D18110ff300218004)。

摘　　要：目的前瞻性调查肝胆外科患者入院时及出院时营养风险等的动态变化。方法分别于入院和出院24小时内对肝胆外科住院患者进行营养相关的人体测量和实验室检查,并应用营养风险筛查(NRS2002)工具,评估住院期间营养风险发生率的变化,并于主要临床结局指标作相关性分析。结果纳入符合入选标准的住院患者600例,其中良性疾病401例,恶性199例;出院时体重、握力、小腿围和血清主要蛋白指标均较入院时均显著降低(P<0.05);出院时营养风险发生率为57.3%,显著高于入院时(χ^(2)=6.512,P=0.011);无论是良性还是恶性疾病,出院时营养风险发生率(49.6%和72.9%)均显著高于入院时(P<0.05)。结论肝胆外科患者营养风险发生率较高,出院时营养风险发生率高于入院时,应重视外科患者的全程营养管理。Objective To investigate the dynamic change of nutritional risk in hepatological surgical patients during hospitalization.Methods Anthropometric measurement and laboratory examination were conducted within 24 hours both after admission and before discharge.NRS 2002 was used to assess patients'nutritional status.The correlation between nutritional status and clinical outcomes was also analyzed.Results A total of 600 patients were included in the study,among whom 401 were with benign diseases and 199 with malignant tumors.Compared with those values at admission,patients'weight,BMI,grip strength,calf circumference and main serum protein indicators decreased significantly at discharge(P<0.05).The incidence of nutritional risk at discharge was 57.3%,higher than that at admission(χ^(2)=6.512,P=0.011).The incidence of nutritional risk showed a significant increase during hospitalization in hepatological surgery patients(P<0.05).Conclusions Hepatological surgery patients were at high nutritional risk,which increased during hospitalization.The whole-course nutrition management of surgical patients should be given more attention.

关 键 词：营养风险 营养治疗 动态调查 术后并发症 医疗花费 

分 类 号：R657.4[医药卫生—外科学] R459.3[医药卫生—临床医学]