摘要
目的应用改良儿科营养不良评估筛查工具（screening tool for the assessment of mal—nutrition in paediatrics，ST AMP）对外科住院患儿进行营养风险评估，并分析营养风险与临床结局的相关性。方法回顾性分析2010年8月至2011年6月入住上海儿童医学中心外科（包括新生儿外科，普外科，泌尿外科，心胸外科，骨科等）的住院1201例患儿的临床数据，根据STAMP评分分为低营养风险组（LNR组，STAMP评分〈4分）900及高营养风险组（HNR组，STAMP评分≥4分）301例，统计分析两组营养干预情况及临床结局数据。其中手术对营养风险的影响采用国家院内感染监控风险指数（national nosocomial infection surveillance risk index，NNIS）进行量化评分。结果HNR组和LNR组的院内感染率分别为4．7％（14／301）和2．1％（19／900）、住院时间分别为（12．59±8．75）d和（10．55±7．69）d、ICU滞留时间分别为（6．59±7．58）d和（3．89±4．25）d、肠外营养使用率分别为17．3％（52／301）和3．1％（28／900）、肠内营养使用率分别为10．0%（30／301）和3．1％（28／900），HNR组均高于LNR组；而治愈率、住院费用两组之间没有显著统计学差异。结论改良STAMP评分可以有效评价住院外科患儿的营养风险，对指导围手术期合理营养干预有参考价值。应用NNIS评分可将手术风险进行量化评估。
Objective To evaluate the efficacy of modified screening tool for assessment of mal- nutrition in pediatric （STAMP） to evaluate nutritional status and clinical outcome in hospitalized chil- dren on a pediatric-surgical ward. Methods In this retrospective cohort study, 1201 hospitalized surgi- cal patients were recruited from August 2010 to June 2011 in a pediatric-surgical ward of Shanghai Children＇s Medical Center. The patients were grouped according to the STAMP Score at admission： low nutritional risk group （LNR, 900 patients with a STAMP Score〈4）, and high nutritional risk group （HNR, 301 patients with a STAMP Score≥4）. The parenteral nutrition （PN） and enteral nu- trition （EN） support and clinical outcome were compared between these 2 groups. The impact of nu- tritional risk of operation was scored by calculating National Nosocomial Infection Surveillance risk in- dex （NNIS）. Results Compared with the LNR patients, the HNR patients had higher nosocomial in- fection rate （4. 7% vs 2. 1/0）, longer length of hospital stay （12. 59 ± 8. 75 d vs 10. 55±7. 69 d）, longer length of ICU stay （6. 59 ± 7. 58 d vs 3.89 ± 4. 25 d）, more PN and EN application （PN, 52/ 31）1 vs 28/900; EN, 30/301 vs 28/900）. No difference of cure rate and medical cost between these 2 groups was found. Conclusions The modified STAMP score is accurate to evaluate the nutritional risk of the hospitalized surgical children. Higher STAMP score is associated with poor clinical outcomes, and indicates nutritional support before or after surgery.
出处
《中华小儿外科杂志》
CSCD
北大核心
2012年第10期742-746,共5页
Chinese Journal of Pediatric Surgery
基金
上海儿童医学中心雅培/世界健康基金会临床营养发展中心（AF1NS）项目（AFINS-HOPE-2011＋21）
关键词
儿童营养障碍
肠内营养
肠外营养
Child nutrition disorders
Enteral nutrition
Parenteral nutrition
