欧洲营养不良风险调查方法在中国住院患者的临床可行性研究

目的检验营养不良风险调查(NRS)判定住院患者营养不良及是否需要营养支持的方法在国内的可行性。方法153例新住院患者参加本研究。入院后首先评估是否符合NRS评定条件,符合者第2天早晨进行评定;对不符合入组条件者检查血清白蛋白(sALB),按中国人正常值sALB<35g/L判定为营养不良。体质指数(BMI)采用中国标准,<18.5kg/m2判定为营养不良。NRS方法(欧洲肠内肠外营养学会2002年发布)由体质指数、近期体重变化、膳食摄入、疾病严重程度等4方面构成,其总评分≥3分判定为需要营养支持。结果139例新住院患者可用NRS评定,营养不良BMI<18.5kg/m2者占15.5%。全部对象的总评分≥3分者33.8%。不宜用NRS评定者14例,因无法站立者9例,胸、腹水者5例。此14例均测sALB,营养不良sALB<35g/L者5例(35.7%)。结论结合中国BMI正常值应用NRS来评定营养不良及判断是否需要营养支持是可行的。对因无法站立等原因而无法准确用NRS者,建议参考sALB<35g/L来判定有无营养不良。更大范围的临床实践有待进一步进行。

Evaluation of European Nutritional Risk Screening Method in Chinese Hospitalized Patients Practice

Objective To evaluate the method from European Nutritional Risk Screen(NRS)method for nutritional risk assessment and estimate if need nutritional support or not in Chinese hospitalized patients practice. Methods One hundred fifty three patients were enrolled in this protocol then they were evaluated if according to assessment condition. The assessment of nutritional risk were carried out in the next morning enrolled, but the patients who could not used NRS would examine the serum albumin(sALB)which < 35 g/L as malnutrition. The body mass index(BMI)was adopted by Chinese standard which lowered than 18.5 kg/m2 as malnutrition. The method of NRS was composed of four parts, for BMI, the change of body weight, the change of diet intake and severity of diseases. The total scores which higher than 3 were justified nutritional risk and needed to nutritional support. Results There were 139 patients could be evaluated by NRS, and 33.8% patients were judged at the risk of malnutrition by NRS. The patients whose BMI< 18.5 kg/m2 were 15.5% in 139 cases. There were 14 patients could not be evaluated by NRS, and 5(35.7%)who sALB lowered than 35 g/L were judged by malnutrition. Among these 14 patients, the patients who could not stand up were 9, who ascites were 5. Conclusions Through this survey, used by NRS(2002)combined with the normal value of BMI of China adults to assess the nutritional state in the inpatients was feasible. In our survey, the patients who could not used by NRS because of could not stand or ascites could be assessed through sALB< 35 g/L. We expected to this clinical practice could be carried out in wider region in future.