中等医院住院病人营养风险筛查的调查与分析

目的调查部分科室住院病人营养不良发生率、营养风险发生率和实际应用营养支持率，为住院病人合理应用营养支持治疗提供参考依据。方法选择某中等医院消化内科、呼吸内科、神经内科、普外科和胸外科新住院病人1000例。病人人院后首先评估是否符合营养风险筛查评定条件，符合者第2天清晨进行评定；对不符合条件病人检测血清清蛋白（sALB），sALB〈30g／L。判定为营养不良。人体质量指数（BMI）〈18．5kg／m^2判定为营养不良。采用营养风险筛查判定是否需要营养支持。结果1000例新住院病人营养风险筛查的完全适用率为77．8％，营养不良发生率为8．6％；营养风险发生率为20．3％。存在营养风险病人中，营养支持率为37．4％，不存在营养风险病人中，营养支持率为13．3％。各科室之间营养不良与营养风险的发生率比较均存在显著性差异（χ^2=20．79、35．95，P〈0．01）。结论住院病人因疾病及其严重程度不同，营养不良的发生率和特点亦不同，营养风险筛查可评估住院病人的营养不良和营养风险。

NUTRITIONAL RISK SCREENING OF IN-PATIENTS IN MEDIUM-SIZED HOSPITAL

Objective To survey the incidence of malnutrition, malnutrition risk, and nutritional support in hospitalized patients and provide reference for rational nutritional support for patients. Methods A survey was conducted in 1 000 patients newly admitted to the departments of gastroenterology, respirology, neurology, general surgery, and thoracic surgery in a mediumsized hospital. On admission, the patients were assessed for nutritional risk screening. For those who met the requirements, an assessment was carried out the next morning; for those unfitted for screening, their serum albumin （sALB）, body mass index （BMI） were detected, sALB〈30 g/L, or BMI〈18.5 kg/m^2 was regarded malnutrition. Nutritional risk screening was used to estimate if nutritional support was needed. Results Of the 1 000 patients studied, the fully applicable rate for nutrition risk screening was 77.8%. The incidence of malnutrition was 8.6% and the nutrition risk rate 20.3 %. For those at nutritional risk, nutritional support rate was 37.4%. For non-rlsk patients, 13.3% received nutritional support. There were significant differences among the five departments studied （χ^2 =20.79,35.95;P〈0.01）. Conclusion The incidence of malnutrition is closely related to the types and severity of the disease that patients suffered. Nutritional risk screening can be used to assess malnutrition and malnutrition risk of inpatients.