CAJ | 학술논문

目的调查内分泌科住院患者营养风险、营养不良(不足)、超重和肥胖发生率及营养支持应用情况.方法采用定点连续抽样,选择2008年9月至12月在北京协和医院内分泌科住院的患者进行营养风险筛查2002(NRS2002),于患者入院次日早晨实施,并调查患者2周内(或至出院时)的营养支持状况,分析营养风险和营养支持之问的关系.NRS2002≥3分为有营养风险,体重指数(BMI)＜18.5 kg/m2并结合患者临床情况判定为营养不足.结果共有152例患者入选并全部完成NRS2002筛查,NRS2002的适用率为100%;营养不足和营养风险的发生率分别为7.9%和27.6%.老年患者(≥60岁)营养风险发生率为36.8%,明显高于中青年患者(18～59岁)的20.2%(P=0.023).在42例有营养风险的患者中,有9例(21.4%)接受了营养支持;在无营养风险的110例患者中,有12例(10.9%)接受了营养支持.所有患者肠外和肠内营养的应用比例为1:3.2.结论 NRS2002适用于内分泌科住院患者的营养筛查.内分泌科有一定量的住院患者存在营养风险或营养不足,营养支持应用仍存在某些不合理性,应推广和应用基于证据的营养支持指南以改善此状况.
목적 조사내분비과주원환자영양풍험、영양불량(불족)、초중화비반발생솔급영양지지응용정황.방법 채용정점련속추양,선택2008년9월지12월재북경협화의원내분비과주원적환자진행영양풍험사사2002(NRS2002),우환자입원차일조신실시,병조사환자2주내(혹지출원시)적영양지지상황,분석영양풍험화영양지지지문적관계.NRS2002≥3분위유영양풍험,체중지수(BMI)＜18.5 kg/m2병결합환자림상정황판정위영양불족.결과 공유152례환자입선병전부완성NRS2002사사,NRS2002적괄용솔위100%;영양불족화영양풍험적발생솔분별위7.9%화27.6%.노년환자(≥60세)영양풍험발생솔위36.8%,명현고우중청년환자(18～59세)적20.2%(P=0.023).재42례유영양풍험적환자중,유9례(21.4%)접수료영양지지;재무영양풍험적110례환자중,유12례(10.9%)접수료영양지지.소유환자장외화장내영양적응용비례위1:3.2.결론 NRS2002괄용우내분비과주원환자적영양사사.내분비과유일정량적주원환자존재영양풍험혹영양불족,영양지지응용잉존재모사불합이성,응추엄화응용기우증거적영양지지지남이개선차상황.
Objective To investigate the prevalence of nutritional risk,malnutrition(undemutrition),overweight/obesity,and application of nutritional support in hospitalized patients with endocrine disorders.Methods Adult patients in Department of Endocrine of Peking Union Medical College Hospital(PUMCH)from September to December 2008 were consecutively enrolled.Nutrional Risk Screening 2002(NRS2002)war per-formed on the next morning after admission and nutritional support evaluation was performed on the 14th day of ad-mission or on the discharge day.The relationship between nutritional risk and nutritional support Was analyzed.Nu-tritional risk was defined as NRS2002 score≥3,and body mass index(BMI)<18.5 ks/m2 defined as unclernut-rition.Results A total of 152 patients were enroled,and NBS2002 scoring was performed in all patients.The prevalence of undernutrition Was 7.9%and the nutritional risk was 27.6%.The prevalence of nutritional risk in the elderly inpotients(≥60 years old)was significantly higher than in younger patients(18-59 years old)(36.8%vs 20.2%,P=O.023).Nine patients(21.4%)with NRS2002≥3 received nutrition support,and 12patients(10.9%)with NRS2002<3 received nutritional support.The average PN:EN ratio was 1:3.2.Conclu-siom NRS2002 is afeasible nutritional risk screening tool for inpatients with endocrine disorders.A large propor-tion of inpotients were at nutritional risk or undemutrition in the Department of Endocrine of PUMCH. The application of nutritional support currently is somehow inappropriate.Evidence-based guidelines are required to improve this situation