不同营养评价方法对高龄老年骨折患者营养状况与切口愈合的临床价值

目的探讨微型营养评价方法(MNA-SF)及营养风险筛查2002(NRS 2002)对评估87例高龄老年骨折患者营养状况和切口愈合的临床价值。方法选择我院2014年6月-2015年12月行手术治疗的87例高龄老年患者,根据两种营养评价方法分别进行营养状况评估,记录手术切口愈合情况。结合体格及实验室检查比较相关性,应用ROC曲线评价两种方法预测患者切口愈合疗效的价值。结果所有患者中切口甲级愈合率66.7%,MNA-SF及NRS 2002营养不良检出率分别为37.9%及27.6%。MNA-SF与BMI、ALB、HB表达呈正相关,NRS2000与BMI、ALB、HB表达呈负相关,两种评价方法中营养状况评价良好的患者切口乙级愈合的发生率明显低于营养状况不良的患者。结论 MNA-SF及NRS 2002在评价高龄老年骨折病人营养状况和切口愈合中均具有良好的临床价值,MNA-SF稍好于NRS 2002。

Clinical value of different nutritional evaluation methods for nutritional status and incision healing in elderly patients with fracture

Objective To study the impact of mini nutritional assessment-SF (MNA-SF) and nutrition risk screening 2002 (NRS2002) on nutritional status and healing of incision among 87 elderly patients with bone fracture.Methods 87 elderly patients diagnosed bone fracture and received surgical procedures in our hospital from June 2014 to December 2015 were included in this study.The MNA-SF and NRS2002 were performed to evaluate nutritional status.Clinical information was documented.To compare the capacity of different evaluating systems, receiver operating characteristic (ROC) was used to validate the accuracy.Result Class-A healing rate of incision was 66.7% in all patients.The malnutrition rate were 37.9% and 27.6% by using MNA-SF and NRS2002 respectively.There was a positive correlation between score of MNA-SF and body mass index.The same results were observed in albumin and HB.However, the negative correlation were found between NRS2002 and above indexes.Class-B healing of incision was less often occurred in well-nourished patients than poorly nourished patients according to both evaluating systems.Area under curve (AUC) for MNA-SF was 0.710 and the sensitivity and specificity of cutoff value were 62.1% and 79.3% respectively.AUC for NRS2002 was 0.641 with the sensitivity and specificity of 48.3% and 82.8% respectively.Conclusion MNA-SF and NRS 2002 allow physicians to evaluate the nutritional status and healing of incision accurately, and MNA-SF was slightly superior to NRS2002.