摘要
目的：了解营养支持对有营养风险胃肠恶性肿瘤病人有无改善临床结局和成本-效果比的影响。方法：2014年12月至2015年8月,以连续抽样方式对胃肠道恶性肿瘤病人营养风险发生率、临床结局和医疗费用进行资料收集。结果：共纳入244例病人,在有营养风险者中,营养支持组总并发症率（31.94%vs 57.89%,P=0.04）以及非感染性并发症的发生率（25.00%vs 52.63%,P=0.02）显著低于无营养支持组。另外,肠内营养组在非感染性并发症风险的减少方面有绝对优势（16.67%vs 52.63%,P=0.03）。多因素分析确认营养支持改善病人总并发症发生率的结论稳定（OR=0.62,95%CI=0.37～0.81,P〈0.01）。存在营养风险且接受营养支持病人的总费用比未接受营养支持者高,两组成本-效果比分别为8 175.9和7 184.9,增量成本-效果比为3 819.2。结论：对胃肠恶性肿瘤有营养风险的病人给予营养支持,可减少并发症的发生率和缩短住院时间,其成本-效果比水平高。
Objective： To investigate whether the use of nutrition support could improve the clinical outcome and cost-effectiveness ratio in the gastrointestinal cancer patients with nutritional risk.Methods： From December 2014 to August 2015,the incidence of nutritional risk,clinical outcome and hospital costs were investigated in hospitalized gastrointestinal cancer patients by continuous sampling method. Results： 244 patients were successfully evaluated with the nutritional risk screening 2002. Of all the patients with nutritional risk,the occurrence rate of total complication was lower in the nutrition support group than in the non-support group（ 31. 94% vs 57. 89%,P = 0. 04）. Furthermore,the improvement in noninfectious complication was also superior to the non-support group（ 25. 00% vs 52. 63%,P= 0. 02）. The enteral nutrition support reduced the occurrence rate of noninfectious complication（ 16. 67% vs 52. 63%,P = 0. 03） and the occurrence rate of total complication（ OR = 0. 62,95% CI =0. 37 ～ 0. 81,P〈0. 01）. The total cost in the patients with nutritional risk receiving nutrition support was higher than the cases without nutrition support. The incremental cost-effectiveness ratio was 3 819. 2.Conclusion： The nutrition support can significantly reduce adverse clinical outcomes,and the patients may benefit from reduction of complications and hospitalization days.
出处
《肠外与肠内营养》
北大核心
2016年第2期78-81,共4页
Parenteral & Enteral Nutrition
基金
安徽省自然科学基金项目(1508085QH152)
国际教育类教学研究项目(gjjyxm201406)
安徽医科大学博士科研资助基金资助(3101005001138)
关键词
营养风险筛查
消化道肿瘤
营养不足
营养支持
临床结局
Nutritional risk screening
Gastrointestinal cancer
Undernutrition
Nutrition support
Clinical outcome
