用不同评价方法调查分析普外科患者术前营养状况

目的了解普外科择期手术患者术前的营养状况，比较不同营养评价方法间的差异。方法采用人体测量法、实验室检查以及问卷量表法评定北京大学第三医院普外科择期手术患者术前的营养状况，分析各营养评价方法的关系。结果共238例患者入选，不同营养评价方法得出患者营养不良发生率不同（5．0％-48．3％），由大到小依次是上臂肌围48．3％，三头肌皮褶厚度32．4％，总淋巴细胞计数20．7％，主观全面评定法（SGA）14．7％，血红蛋白11．4％，体重10．5％，营养评价简易问卷法（SNAQ）9．7％，简易营养评定法（MNA）8．4％，Nottingham筛查量表8．0％，体质指数7．1％，白蛋白5．0％。各种营养状况评价方法之间具有相关性。结论可采用综合营养评价方法进行普外科患者术前营养评估，或先采用简单、快速的评定方法进行初步营养筛查，之后结合人体测量或实验室检查法进行进一步诊断。

Assessment of Pre-operative Nutrition Status of General Surgical Patients with Different Methods

Objective To assess the nutrition status of general surgical patients before selective operations with different methods. Methods The nutrition status of patients before selective operations in the Department of General Surgery of Peking University Third Hospital were assessed with body physical measurement, laboratory tests, and questionnaires. The relationship of different methods and techniques were analyzed. Results Different assessment methods showed different malnutrition rates, which were 48.3 % 10.5% , 9.7% , 8.4% , 8.0% , 7.1% , and 5.0% , respectively, as ,32.4%,20.7%, 14. 7%, 11.4%, shown by arm muscle circumference,triceps skin fold thickness, total lymphocyte count, Subject Global Assessment （SGA） , hemoglobin, body weight, Short Nutritional Assessment Questionnaire （SNAQ）, Mini Nutritional Assessment （MNA） , Nottingham, body mass index, and albumin. Correlations were found among different nutrition assessment methods and techniques. Conclusions Combined nutrition assessment methods can be used for patients in the general surgery. Alternatively, simple and fast assessment can be used for initial nutrition screening, and then using physical measurement or laboratory tests for further examinations.