营养风险筛查NRS2002在消化科住院患者中的应用

发布时间：2018-02-13 15:45

本文关键词： 营养不良营养风险营养支持营养风险筛查2002　出处：《苏州大学》2015年硕士论文　论文类型：学位论文

【摘要】：[目的]调查并分析消化科住院患者NRS2002的适用率,及NRS2002与营养不良发生率、营养风险发生率、营养支持情况、并发症、住院天数的关系。以了解是否能应用筛查住院病人的营养状况,为临床医生进行营养支持提供依据,以利于早期介入营养支持改善患者的临床结局。[方法]选择2014年11月至12月入住我院消化科的245例患者作为研究对象,新住院患者采用定点连续抽样方法,符合标准者在入院48小时内完成NRS2002。采集病人体重、身高及病史,BMI18.5kg/m2判定有营养不良,对于不能站立、有严重胸腹水或水肿而无法获得准确体重、身高者(即无法获得BMI者),采用s ALB30g/L评估是否存在营养不良。同时结合患者疾病严重程度、饮食摄入情况及近期体重变化情况评价营养状况,并结合临床实际情况做出评分。相关数据资料制定成登记表,记录并判断研究对象是否需要营养支持、实际营养支持情况、并发症、住院天数及临床结局等。将记录入Microsoft Excel 2007 for Windows,建立数据库,采用IBM SPSS 21软件进行统计学处理。[结果]在245例患者中,237例患者完成了营养风险筛查,NRS2002适用率96.73%,其中男性138例,占58.23%,女性99例,占41.77%;平均年龄56.16±15.88岁;营养不良发生率17.30%;营养风险发生率40.51%。恶性肿瘤的营养风险发生率最高,占25.0%;消化道息肉营养风险最低,占1.04%。营养支持部分,PN及EN比例48:1,提示存在PN应用过度、EN应用不足的现象。并发症中有营养风险的患者发生率较高(χ2=30.652,p0.05)。有营养风险患者住院时间较长(t=5.870,p0.05)。[结论]住院患者的营养不良问题及营养风险是普遍存在的,本研究中发现年龄、住院天数、并发症发生率与营养风险显著相关。目前临床上营养支持普遍出现不足与过度的现象。NRS2002营养风险筛查具有足够的可行性,其简便易行、无创且可操作性高,患者配合度高,可推荐普遍临床使用。
[Abstract]:[objective] to investigate and analyze the applicable rate of NRS2002, the incidence of NRS2002 and malnutrition, the incidence of nutritional risk, nutritional support and complications in inpatients with digestive department. The relationship between days of stay in hospital. In order to understand whether it can be used to screen the nutritional status of hospitalized patients, and to provide the basis for nutrition support by clinicians, [methods] A total of 245 patients admitted to the Department of Digestive Medicine from November 2014 to December were selected as study subjects. Those who met the criteria completed NRS 2002.The weight, height and history of the patients were collected within 48 hours of admission. BMI18.5 kg / m2 determined that they had malnutrition, that they could not get accurate weight because they could not stand up, had severe hydrothorax or ascites, or had edema. Height (that is, those who could not obtain BMI) was assessed with s ALB30g/L for malnutrition. The nutritional status was evaluated with the severity of disease, dietary intake and recent weight changes. And according to the actual clinical situation to make a score. The relevant data and materials were made into a registration form, recorded and judged whether the study object needs nutritional support, actual nutritional support situation, complications, The days of hospitalization and clinical outcome were recorded in Microsoft Excel 2007 for Windows, the database was established, and the statistical analysis was carried out with IBM SPSS 21 software. [results] among 245 patients, 237 patients completed nutritional risk screening and the applicable rate of NRS2002 was 96.73. Among them, 138 were male. The incidence of malnutrition was 17.30%. The incidence of nutritional risk was 40.51%. The incidence of nutritional risk of malignant tumors was the highest (25.0%); the nutritional risk of digestive tract polyps was the lowest. The proportion of PN to en was 48: 1, indicating that there was insufficient use of PN. The incidence of nutritional risk in patients with complications was higher (蠂 2 + 30.652%, p 0.05). The hospitalization time of patients with nutritional risk was 5.870% (P 0.05). [conclusion] inpatients with nutritional risk are in hospital. [conclusion] the incidence of nutritional risk in patients with nutritional risk is higher than that in patients with nutritional risk. [conclusion] inpatients with nutritional risk have a higher incidence of nutritional risks (蠂 2, 30.652%, p 0.05). Malnutrition and nutritional risks are widespread among people. In this study, we found that age, length of stay in hospital, incidence of complications were significantly correlated with nutritional risk. At present, nutritional support is generally inadequate and excessive in clinical practice. NRS2002 nutritional risk screening is feasible and easy to carry out. Non-invasive, high maneuverability, high patient cooperation, can be recommended for general clinical use.
【学位授予单位】：苏州大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R197.3;R459.3

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