内科住院患者营养不足、营养风险和营养支持状况

目的调查内科住院患者营养不足、营养风险和营养支持应用状况。方法采用定点连续抽样,选择内科系统住院患者398例,采用欧洲肠外肠内营养学会推荐的营养风险筛查工具NRS2002做营养不足和营养风险筛查,NRS2002≥3分为有营养风险,体质量指数(BMI)<18.5 kg/m2并结合临床一般情况差判定为营养不足。同时调查患者住院期间的肠内肠外营养支持情况。结果 398例内科住院患者营养不足和营养风险发生率分别为14.1%和33.7%;营养不足发生率居前两位的是消化内科(19.6%)和肿瘤内科(16.9%);免疫科(8.6%)发生率低。营养风险发生率占前3位的是肿瘤内科(47.5%),消化内科(42.9%)和神经内科(41.7%),内分泌科(21.4%),免疫科(13.8%)发生率低。398例患者中,31例应用肠内营养(EN),92例应用肠外营养(PN),8例同时应用肠内肠外营养,PN∶EN=3∶1;有营养风险患者营养支持率为70.9%,无营养风险患者营养支持率为13.6%;有营养不足患者营养支持率为96.4%,无营养不足患者营养支持率为22.5%。结论消化内科、肿瘤内科、神经内科营养不足或营养风险发生率较高。建议重视肠内营养支持,提高肠内营养应用比例。

Malnutrition,nutritional risk and nutritional support in hospitalized patients in medical wards

Objective To investigate the prevalence of malnutrition,nutritional risk and application of nutritional support in hospitalized patients in medical wards.Methods 398 adult patients in medical wards of Beijing Hospital from April to June in 2011 were consecutively enrolled.The patients were screened using Nutritional Risk screening 2002（NRS2002） on admission NRS2002 score≥3 was classified as nutritional risk of BMI18.5 kg/m2 with impaired general condition was defined as malnutrition.The nutritional support application during hospital stay was recorded.Results The prevalence of malnutrition was 14.1% and the nutritional risk was 33.7% in all 398 patients.The prevalences of malnutrition in Gastroenterology and Oncology wards were significantly higher than that in Immunity ward.The prevalence of nutritional risk in Oncology,Gastroenterology and Neurology wards were significantly higher than in Endocrinology and Immunology wards.70.9%（95/134） patients with NRS2002≥3 received nutritional support,and 13.6%（36/264） patients with NRS20023 received nutritional support.96.4%（54/56） patients with malnutrition received nutritional support,and 22.5%（77/342） patients with no-malnutrition received nutritional support.The average PN：EN ratio was 3∶ 1.Conclusions The prevalence of malnutrition and nutritional risk is high in Gastroenterology,Oncology and Neurology wards.More attention should be payed on the enteral nutrition,which may be performed first in the malnutrition or nutritional risk inpatients.