营养支持对高营养风险患儿临床结局的影响

目的探讨营养支持对有高营养风险患儿临床结局的影响。方法应用改良的儿科营养不良筛查评分法(STAMP),对连续入院的1 296例患儿进行营养风险筛查评分,并分析营养支持对临床结局的影响。结果 1 296例住院患儿中,379例STAMP评分≥4分,高营养风险检出率为29.24%。304例患儿纳入进一步分析,其中85例(27.96%)有营养支持。营养支持患儿中,37例肠外营养支持(PN),23例肠内营养支持(EN),25例PN和EN联合应用;EN、PN、PN和EN联合应用比较,人均和日均营养支持费用的差异有统计学意义(P均0.001);EN的人均和日均费用均为最低。与无营养支持患儿比较,营养支持患儿感染发生率有所降低,但差异无统计学意义(P=0.095);无营养支持患儿抗感染治疗费用高于有营养支持患儿,抗生素治疗费用也明显高于有营养支持患儿,差异均有统计学意义(P均0.001)。无营养支持、EN、PN、PN+EN四组间住院费用差异有统计学意义(P=0.003),而四组间住院时间差异无统计学意义(P=0.213)。结论改良的STAMP评分作为儿科患者营养风险筛查工具简单实用;不同的营养支持方式费用存在差异;营养支持可有效改善临床结局,特别是减少感染和降低抗感染治疗费用。

The clinical outcomes of nutritional support in children with high nutritional risk

Objective To explore the clinical outcomes of nutritional support in children with high nutritional risk. Methods Improved screening tool for the assessment of malnutrition in pediatrics (STAMP) was used to make nutritional risk score in 1296 cases of consecutively hospitalized patients, and to analysis the effects of nutrition support in clinical outcome. Results In these 1296 hospitalized patients, 379 cases had STAMP score?≥?4 and the detection rate of high nutritional risk was 29 . 24 %. A total of 304 cases were included for further analysis, including 85 cases ( 27 . 96 %) of nutritional support, among whom there were 37 cases of parenteral nutrition (PN), 23 cases of enteral nutrition (EN), 25 cases of combined application of EN and PN. Per capita and daily mean support cost were statistically different among patients with EN, PN and combination of PN and EN (P all?