CAJ | 학술논문

目的调查手术治疗的妇科恶性肿瘤住院患者营养风险和营养不足发生率以及营养支持状况.方法采用定点连续抽样,以2013年1月1日至12月31日在北京医院妇科住院、接受手术治疗的237例恶性肿瘤患者为研究对象,入院后第2天早晨进行营养风险筛查,营养风险筛查评分≥3分认为存在营养风险,营养不足判断标准遵循营养风险筛查2002方法,描述其术后营养支持状态.结果营养风险筛查的适用率为100％;营养不足占5.1％ (12/237),其中≥65岁者营养不足发生率(9.2％)显著高于＜65岁者(2.7％)(P=0.034);妇科恶性肿瘤总营养风险发生率为21.1％(50/237),其中≥65岁者营养风险发生率(29.9％)显著高于＜65岁者(16.0％)(P=0.014);卵巢癌和子宫内膜癌患者的营养不足和营养风险发生率相对较高,而阴道癌和外阴癌患者的发生率相对较低;237例患者中,术后接受营养支持者共47例(19.8％),均为肠外营养,其中,应用“全合一”肠外营养者13例(5.5％),单瓶输注(给予“葡萄糖、脂肪乳、氨基酸”中两种以上者)34例(14.3％).无接受管饲肠内营养的病例;存在营养风险的50例患者中,接受肠外营养支持33例(66％);无营养风险的187例患者中,接受肠外营养支持14例(7.5％).结论妇科恶性肿瘤住院患者存在营养风险;但老年患者营养风险发生率较高,应加强对老年患者的术后营养支持.
목적 조사수술치료적부과악성종류주원환자영양풍험화영양불족발생솔이급영양지지상황.방법 채용정점련속추양,이2013년1월1일지12월31일재북경의원부과주원、접수수술치료적237례악성종류환자위연구대상,입원후제2천조신진행영양풍험사사,영양풍험사사평분≥3분인위존재영양풍험,영양불족판단표준준순영양풍험사사2002방법,묘술기술후영양지지상태.결과 영양풍험사사적괄용솔위100％;영양불족점5.1％ (12/237),기중≥65세자영양불족발생솔(9.2％)현저고우＜65세자(2.7％)(P=0.034);부과악성종류총영양풍험발생솔위21.1％(50/237),기중≥65세자영양풍험발생솔(29.9％)현저고우＜65세자(16.0％)(P=0.014);란소암화자궁내막암환자적영양불족화영양풍험발생솔상대교고,이음도암화외음암환자적발생솔상대교저;237례환자중,술후접수영양지지자공47례(19.8％),균위장외영양,기중,응용“전합일”장외영양자13례(5.5％),단병수주(급여“포도당、지방유、안기산”중량충이상자)34례(14.3％).무접수관사장내영양적병례;존재영양풍험적50례환자중,접수장외영양지지33례(66％);무영양풍험적187례환자중,접수장외영양지지14례(7.5％).결론 부과악성종류주원환자존재영양풍험;단노년환자영양풍험발생솔교고,응가강대노년환자적술후영양지지.
Objective To investigate the prevalence of nutritional risk and malnutrition,and the application of nutrition support in hospitalized patients with surgically treated gynecologic malignant tumors.Methods 237 hospitalized patients with malignant tumors receiving surgery in Department of Gynecology of Beijing Hospital from January 1 to December 31,2013 were continuously sampled.Nutritional Risk Screening 2002 (NRS 2002) was performed in the morning the day after admission.NRS 2002 score ≥ 3 was considered indicating nutritional risk.Malnutrition was judged in accordance with NRS 2002.The application of postoperative nutrition support was recorded.Results The nutritional risk screening was applicable in all the patients (100％).The prevalence of malnutrition was 5.1％ (12/237) in the whole study population,9.2％ in the elderly (≥65 years),significantly higher than that in the patients ＜ 65 years (2.7％) (P =0.034).The nutritional risk rate was 21.1％ (50/237),which was 29.9％ in the patients ≥ 65 years and significantly lower in the patients ＜ 65 years (16.0％) (P =0.014).The nutritional risk rate in the patients with ovarian and endometrial cancers was higher the rate in those patients with vaginal and vulvar cancer was lower.47 patients (19.8％)received postoperative nutrition support,all being parenteral nutrition,including total parenteral nutrition in 13 patients (5.5％) and single transfusion (providing two or more than two amongs glucose,fat emulsion,andi amino acids) in 34 (14.3％).Tube feeding was not applied in all the patients.33 cases (66％) in the 50 patients with nutritional risk were supported by parenteral nutrition,while 14 cases (7.5％) in the 187 patients without nutritional risk were supported by parenteral nutrition.Conclusions There is nutritional risk in the patients with gynecology malignant tumors,the rate of which is higher in elderly patents (≥ 65 years) than in the patients of other age groups.Therefore,attention must be paid to ensure adequate postoperative nutrition support in the elderly patients.