肝硬化患者营养状态的主观全面营养评估

目的将主观全面营养评估(subjective global assessment,SGA)用于评估肝硬化患者的营养状况,分析患者的营养状况与肝脏功能状态之间的关系。方法选取2010年1月-2013年1月入住遂宁市中心医院消化内科的177例肝硬化患者,入院后48~72 h内完成对患者入院时营养状况进行评价,并随访半年。将患者Child-Pugh评分情况与SGA营养状况相比较。统计分析不同营养状态患者的体质量、体质量指数(BMI)、中臂围、三头肌皮褶厚度以及饮食情况。结果严重营养不良的患者体质量、BMI、中臂围、三头肌皮褶厚度与营养状况良好的患者相比差异有统计学意义(P0.05)。132例患者饮食合理,且营养状况均良好,但45例不合理饮食的患者仅有2例营养状况良好,17例轻-中度营养不良,26例严重营养不良。经SGA评估患者营养状况良好的患者109例,其中Child A 65例,Child B 44例。重度营养不良患者26例,其中Child B 15例,Child C 11例。结论 SGA可用于评估肝硬化患者的营养状态。患者营养状态与肝脏储备功能Child分级相关。

Subjective global assessment of nutritional status in patients with cirrhosis

Objective To assess the nutritional status of patients with cirrhosis by subjective blobal assessment （SGA）,and to analyze the relationship between the nutritional status and liver function.Methods One hundred and seventy-seven cirrhotic patients admitted in Suining Central Hospital from Jan.2010 to Jan.2013 were included in the study.Nutritional assessment were completed within 48 to 72 hours after admission,and these patients were followed-up six months.The Child-Pugh score and SGA were compared.The different nutritional status of the patients＇ weight,BMI,mid arm circumference,triceps skinfold thickness and diet were statistically analyzed.Results The weight,BMI,mid arm circumference,triceps skinfold thickness of severely malnourished patients had statistically significant differences （P ＜0.05） compared with well nourished individuals.One hundred and thirty-two patients with reasonable diet were well nourished.However,45 cases of unreasonable diet patients had only 2 cases of patients with good nutrition,17 cases of mild to moderate malnutrition,and 26 cases of severe malnutrition.Patients who were assessed by SGA had 109 cases of good nutrition,included Child A 65 cases,Child B 44 cases.There were 26 cases of patients with severe malnutrition,included Child B 15 cases,Child C 11 cases.Conclusion SGA can be used to assess the nutritional status of patients with cirrhosis.Patients with poorer nutritional status will get a higher grade of liver funtion and greater likelihood of complications.