本文關(guān)鍵詞： 營養(yǎng)不良 營養(yǎng)風(fēng)險(xiǎn) 營養(yǎng)支持 營養(yǎng)風(fēng)險(xiǎn)篩查2002　出處：《蘇州大學(xué)》2015年碩士論文　論文類型：學(xué)位論文

【摘要】：[目的]調(diào)查并分析消化科住院患者NRS2002的適用率,及NRS2002與營養(yǎng)不良發(fā)生率、營養(yǎng)風(fēng)險(xiǎn)發(fā)生率、營養(yǎng)支持情況、并發(fā)癥、住院天數(shù)的關(guān)系。以了解是否能應(yīng)用篩查住院病人的營養(yǎng)狀況,為臨床醫(yī)生進(jìn)行營養(yǎng)支持提供依據(jù),以利于早期介入營養(yǎng)支持改善患者的臨床結(jié)局。[方法]選擇2014年11月至12月入住我院消化科的245例患者作為研究對象,新住院患者采用定點(diǎn)連續(xù)抽樣方法,符合標(biāo)準(zhǔn)者在入院48小時(shí)內(nèi)完成NRS2002。采集病人體重、身高及病史,BMI18.5kg/m2判定有營養(yǎng)不良,對于不能站立、有嚴(yán)重胸腹水或水腫而無法獲得準(zhǔn)確體重、身高者(即無法獲得BMI者),采用s ALB30g/L評估是否存在營養(yǎng)不良。同時(shí)結(jié)合患者疾病嚴(yán)重程度、飲食攝入情況及近期體重變化情況評價(jià)營養(yǎng)狀況,并結(jié)合臨床實(shí)際情況做出評分。相關(guān)數(shù)據(jù)資料制定成登記表,記錄并判斷研究對象是否需要營養(yǎng)支持、實(shí)際營養(yǎng)支持情況、并發(fā)癥、住院天數(shù)及臨床結(jié)局等。將記錄入Microsoft Excel 2007 for Windows,建立數(shù)據(jù)庫,采用IBM SPSS 21軟件進(jìn)行統(tǒng)計(jì)學(xué)處理。[結(jié)果]在245例患者中,237例患者完成了營養(yǎng)風(fēng)險(xiǎn)篩查,NRS2002適用率96.73%,其中男性138例,占58.23%,女性99例,占41.77%;平均年齡56.16±15.88歲;營養(yǎng)不良發(fā)生率17.30%;營養(yǎng)風(fēng)險(xiǎn)發(fā)生率40.51%。惡性腫瘤的營養(yǎng)風(fēng)險(xiǎn)發(fā)生率最高,占25.0%;消化道息肉營養(yǎng)風(fēng)險(xiǎn)最低,占1.04%。營養(yǎng)支持部分,PN及EN比例48:1,提示存在PN應(yīng)用過度、EN應(yīng)用不足的現(xiàn)象。并發(fā)癥中有營養(yǎng)風(fēng)險(xiǎn)的患者發(fā)生率較高(χ2=30.652,p0.05)。有營養(yǎng)風(fēng)險(xiǎn)患者住院時(shí)間較長(t=5.870,p0.05)。[結(jié)論]住院患者的營養(yǎng)不良問題及營養(yǎng)風(fēng)險(xiǎn)是普遍存在的,本研究中發(fā)現(xiàn)年齡、住院天數(shù)、并發(fā)癥發(fā)生率與營養(yǎng)風(fēng)險(xiǎn)顯著相關(guān)。目前臨床上營養(yǎng)支持普遍出現(xiàn)不足與過度的現(xiàn)象。NRS2002營養(yǎng)風(fēng)險(xiǎn)篩查具有足夠的可行性,其簡便易行、無創(chuàng)且可操作性高,患者配合度高,可推薦普遍臨床使用。
[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.
【學(xué)位授予單位】：蘇州大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2015
【分類號】：R197.3;R459.3

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