CAJ | 학술논문

目的调查普通外科住院患者入院时的营养风险及住院期间的营养支持状况,分析营养风险、营养支持与临床结局的关系.方法采用营养风险筛查2002( NRS 2002),选取2009年9月至2010年4月在上海市第六人民医院普通外科的住院患者进行营养风险筛查,并调查患者2周内的营养支持状况,统计并发症发生率、住院时间和住院费用.结果共有3000例住院患者入选,总营养风险发生率为18.5％,胃肿瘤患者营养风险最高,为48.3％.存在营养风险和无营养风险患者的营养支持率分别为44.1％和14.3％.肠外营养和肠内营养比值为1.2:1.有营养风险的患者并发症发生率、住院时间和总住院费用均高于无营养风险的患者[24.1％比14.2％,(11.1±4.8)d比(9.6±3.7)d,(12 891.5 ±4831.2)元比(9982.7±3996.4)元,P均=0.0000).在有营养风险的胃肿瘤、结直肠肿瘤和肝胆胰肿瘤患者中,应用营养支持患者的并发症发生率、平均住院时间和住院费用明显低于未用营养支持的患者(P均＜0.05).结论普通外科住院患者存在营养风险,其中胃肿瘤患者营养风险较高.营养风险与外科住院患者的临床结局有关.对有营养风险的胃肿瘤、结直肠肿瘤和肝胆胰肿瘤患者,给予营养支持可改善临床结局.
목적조사보통외과주원환자입원시적영양풍험급주원기간적영양지지상황,분석영양풍험、영양지지여림상결국적관계.방법채용영양풍험사사2002( NRS 2002),선취2009년9월지2010년4월재상해시제륙인민의원보통외과적주원환자진행영양풍험사사,병조사환자2주내적영양지지상황,통계병발증발생솔、주원시간화주원비용.결과 공유3000례주원환자입선,총영양풍험발생솔위18.5％,위종류환자영양풍험최고,위48.3％.존재영양풍험화무영양풍험환자적영양지지솔분별위44.1％화14.3％.장외영양화장내영양비치위1.2:1.유영양풍험적환자병발증발생솔、주원시간화총주원비용균고우무영양풍험적환자[24.1％비14.2％,(11.1±4.8)d비(9.6±3.7)d,(12 891.5 ±4831.2)원비(9982.7±3996.4)원,P균=0.0000).재유영양풍험적위종류、결직장종류화간담이종류환자중,응용영양지지환자적병발증발생솔、평균주원시간화주원비용명현저우미용영양지지적환자(P균＜0.05).결론보통외과주원환자존재영양풍험,기중위종류환자영양풍험교고.영양풍험여외과주원환자적림상결국유관.대유영양풍험적위종류、결직장종류화간담이종류환자,급여영양지지가개선림상결국.
Objective To determine the prevalence of nutritional risk and application of nutrition support in hospitalized patients in the department of general surgey,and to evaluate the relationship between nutrition support and clinical outcome as well as between nutritional risk and clinical outcome.Methods Hospitalized patients in the department of general surgery were enrolled from September 2009 to April 2010.The patients were screened using Nutritional Risk Screening 2002 ( NRS 2002) on admission.Data were collected on the application of nutrition support within 2 weeks,complication rate,length of stay,and hospital charges.Results Altogether 3000 patients were included in the present study.The overall prevalence of nutritional risk was 18.5％,in which gastric cancer patients showed the highest prevalence (48.3％ ).The proportion of patients receiving nutrition support was 44.1％ in those with nutritional risk and 14.3％ in those without nutritional risk.The ratio of parenteral nutrition to enteral nutrition was 1.2:1.The patients with nutritional risk had higher complication rate,longer length of stay,and higher hospital charge [24.1％ vs.14.2％,(11.1 ±4.8) daysvs.(9.6±3.7) days,(12891.5±4831.2) yuan vs.(9982.7 ±3996.4) yuan,all P=0.0000].Among the gastric cancer,colorectal cancer,and hepato-biliopancreatic cancer patients with nutritional risk,the complication rate,length of stay,and hospital charge were significantly lower in the patients receiving nutrition support than those in the patients receiving no nutrition support ( all P ＜ 0.05 ).Conclusions A number of inpatients in general surgery department are at nutritional risk.The prevalence of nutritional risk is considerably high in gastric cancer patients.Nutritional risk is correlated with the clinical outcome of the patients.Nutrition support may improve the clinical outcome of gastric cancer,colorectal cancer,and hepato-bilio-pancreatic cancer patients.