我院恶性肿瘤住院患者营养状态与营养干预情况调查
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篇名: 我院恶性肿瘤住院患者营养状态与营养干预情况调查
TITLE:
摘要: 目的:为加强对恶性肿瘤患者的合理营养干预提供参考。方法:以2016年9月-2017年10月我院诊断为恶性肿瘤的住院患者191例为对象,由营养支持药师分别运用营养风险筛查量表(NRS)2002和整体营养状况主观评估量表(PG-SGA)在其入院48 h之内进行营养状态评估,同时调查其住院期间接受营养干预的情况。结果:191例患者中,NRS 2002总评分≥3分(存在营养风险)的有123例,总体营养风险发生率为64.40%;PG-SGA评级为B级和C级(存在营养不良)的有129例,总体营养不良发生率为67.54%,且年龄<60岁和年龄≥60岁的患者营养不良发生率比较差异有统计学意义(P<0.05)。NRS 2002与PG-SGA评估结果的一致性检验Kappa=0.557(P<0.001),一致性程度属于中等。191例患者中只有46例接受了营养干预(给予全肠内营养的仅有2例),总体干预率为24.08%;其中,存在营养风险的患者干预率仅为34.15%(42/123),存在营养不良的患者干预率仅为31.78%(41/129)。结论:恶性肿瘤患者尤其是老年患者的营养风险和营养不良发生率较高,但临床营养干预存在明显不足,且全肠内营养的应用率较低。故需要营养支持药师协助和配合医师,结合NRS 2002和PG-SGA两个工具,及时、有效地将入院时已经存在营养风险或营养不良的患者筛查出来,综合评估其营养状态,从而给予适当的营养干预。
ABSTRACT: OBJECTIVE: To provide reference for strengthening the rational nutritional intervention of patients with malignant tumor. METHODS:From Sept. 2016 to Oct. 2017, 191 inpatients diagnosed as malignant tumor in our hospital were targeted. Nutritional support pharmacist used Nutritional Risk Screening 2002 (NRS 2002) and Patient-generated Subjective Global Assessment (PG-SGA) to conduct nutritional status assessment within 48 h of admission; at the same time, nutritional intervention for patients during hospitalization was investigated. RESULTS: Among 191 patients, NRS 2002 score ≥3 (with nutritional risk) was classified in 123 cases, and total incidence of nutritional risk was 64.40%. Totally 129 cases were classified into grade B and C (malnutrition) by PG-SGA, and total incidence of malnutrition was 67.54%. There was statistical significance in the incidence of malnutrition among patients aged below 60 years old and patients aged more than 60 years old (P<0.05). NRS 2002 and PG-SGA showed a consistency of Kappa=0.557 (P<0.001), with moderate consistency degree. Of 191 patients, only 46 received nutritional intervention (only 2 cases received total enteral nutrition), and the overall intervention rate was 24.08%. Among them, the intervention rate of patients with nutritional risk was only 34.15% (42/123), and the intervention rate of patients with malnutrition was 31.78% (41/129). CONCLUSIONS: The incidence of nutritional risk and malnutrition among patients with malignant tumors is high, especially in elderly patients. But clinical nutrition interventions are obviously inadequate and the application rate of enteral nutrition support is low. Therefore, nutritional support pharmacists are required to assist and cooperate with physicians, combined two tools as NRS 2002 and PG-SGA that can promptly and effectively screen patients who already have nutritional risk or malnutrition on admission and comprehensively evaluate their nutritional status, so as to give appropriate nutritional intervention.
期刊: 2018年第29卷第10期
作者: 鲁良秀,秦侃
AUTHORS: LU Liangxiu,QIN Kan
关键字: 恶性肿瘤;营养风险筛查量表2002;整体营养状况主观评估量表;营养风险;营养不良;营养干预;调查
KEYWORDS: Malignant tumor; Nutritional Risk Screening 2002; Patient-generated Subjective Global Assessment; Nutritional risk; Malnutrition; Nutritional intervention; Investigation
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