摘要
目的:调查我院腹部外科手术患者营养风险现患率和营养支持治疗的现状。方法:采用回顾性定点连续抽样法,选取2021年10月-2022年10月我院收治的腹部外科手术患者,入院24 h内行营养风险筛查(NRS2002),分析患者营养风险发生情况、是否给予营养支持治疗以及营养支持治疗的方式等。结果:符合条件入组的腹部外科入院患者1401例,其中具有营养风险(NRS2002评分≥3分)的患者435例,无营养风险的患者(NRS2002评分<3分)966例,营养风险现患率为31.05%(435/1401)。营养不良指体质指数(BMI)<18.5 kg/m2或白蛋白<30 g/L的患者90例,本研究中营养不良现患率为6.42%(90/1401)。具有营养风险的435例患者中,293例(67.36%)于营养筛查后的7 d内给予营养支持治疗,142例(32.64%)7 d内未给予营养支持治疗。无营养风险的966例患者中,516例(53.42%)7 d内给予营养支持治疗,450例7 d内未给予营养支持治疗(46.58%)。具有营养风险并给予营养支持治疗的293例患者中,133例(45.39%)使用肠外营养(PN),44例(15.02%)使用肠内营养(EN),116例(39.59%)使用PN+EN。1401例患者中,手术患者615例,NRS2002评分≥3分的180例,营养风险现患率29.27%,非手术患者786例,NRS2002评分≥3分的255例,营养风险现患率32.44%,两组营养风险现患率无明显差异(P>0.05)。615例手术患者中,胆囊胆管手术420例,NRS2002评分≥3分111例,营养风险现患率26.35%,胰腺手术191例,NRS2002评分≥3分68例,营养风险现患率35.60%,胰腺手术组的营养风险现患率高于胆囊胆管手术,差异有统计学意义(P <0.05)。结论:腹部外科手术患者的营养支持治疗率不足,营养支持治疗方式以PN为主,胰腺手术患者营养风险现患率高于胆囊胆管手术患者。
Objective To investigate the application status of nutritional risk screening and nutritional support in patients undergoing abdominal surgery.Methods A consecutive series of patients admitted for selective abdominal surgery in the Tianjin Hospital of ITCWM Nankai Hospital were recruited from October 2021 to October 2022.Data were collected on the basic information,nutritional risk screening(NRS2002),the application of adequate nutritional support,PN or EN or PN+EN.Results A total of 1401 eligible patients were enrolled,including 435 patients with nutritional risk(NRS2002≥3 points)and 966 patients with no nutritional risk(NRS2002<3 points).The incidence rate of nutritional risk among patients admitted for abdominal surgery was 31.05%.In 90 patients with body mass index(BMI)<18.5 kg/m2 or albumin<30 g/L,the prevalence of malnutrition was 6.42%.Among the 435 patients with nutritional risk,293(67.36%)received nutritional support within 7 days after nutritional screening,and 142(32.64%)did not receive nutritional support within 7 days.Of the 966 patients with no nutritional risk,516(53.42%)received nutritional support within 7 days and 450(46.58%)did not receive nutritional support within 7 days.Patients at nutritional risk who received nutritional support therapy of 293 patients,133(45.39%)used PN,44(15.02%)used EN,and 116(39.59%)used PN+EN.The rates of nutritional risk in 615 surgery patients was 29.27%,and the rates of nutritional risk in 786 non-surgery patients was 32.44%,and there was no obviously differnt between them(P>0.05).The rates of nutritional risk in 420 gallbladder and biliary surgery patients was 26.43%,and the rates of nutritional risk in 191 pancreatic surgery patients was 35.60%.There was obviously differnt between them(P< 0.05).Conclusion The application of nutrition support in our abdominal surgery patients is insuficient in this hospital.Parenteral nutrition remains the most common type of nutrition support.The incidence of nutritional risk in patients undergoing pancreatic surgery was higher than that in patients undergoing cholecystobile duct surgery.
作者
于福文
王辰茜
田书霞
YU Fuwen;WANG Chen-xi;TIAN shu-xia(Tanjin Hospial ITCWM Nankai Hospial,Tianjin,300100,China)
出处
《中国中西医结合外科杂志》
CAS
2024年第1期100-104,共5页
Chinese Journal of Surgery of Integrated Traditional and Western Medicine
