北京教学医院普通外科住院患者营养风险、营养不足、超重、肥胖及营养支持状况

目的调查北京教学医院普通外科住院患者人院和入院2周（或出院）时营养风险、营养不足、超重、肥胖和营养支持的状况。方法采用定点连续抽样，选择2007年3月至6月在北京3家教学医院普通外科住院患者进行营养风险筛查，使用营养风险筛查2002（NRS2002）于患者入院和入院2周（或出院）时实施，并调查患者2周内（或至出院时）的营养支持状况，分析营养风险和营养支持之间的关系。NRS200293分为有营养风险，体重指数（BMI）〈18．5kg／m2并结合患者临床情况判定为营养不足。结果300例入选者中，有297例完成筛查，NRS2002适用率为99．0％。入院时总营养风险发生率为30．0％，营养不足、超重和肥胖的发生率分别为8．1％、38．3％和9．4％。存在营养风险和无营养风险患者的营养支持率分别为62．2％和19．O％。在接受腹部大手术的患者中，有营养风险和无营养风险患者的营养支持率分别为71．6％和43．2％。入院和入院2周（或出院）时的总营养风险发生率分别为30．0％和35．8％，两者相比差异无统计学意义（x2=2．271，P=0．132）。结论NRS2002适用于普通外科住院患者的营养筛查。临床营养支持在普通外科得到了充分重视，但临床上存在肠外、肠内营养的不合理应用。住院期间未观察到患者营养风险发生率的变化．

Prevalences of nutritional risk,undernutrition-overweight,and obesity as well as nutritional support in hospitalized general surgical patients in Beijing teaching hospitals

Objecflve To determine the prevalences of nutritional risk,undemutrition,overweight,and obesity as well as nutritional support and the changes of nutritional risks from admission to discharge or over a two-week period.Methods A consecutive sampling was performed.Dam were collected from general surgical depart-ments in three Beijing teaching hospitals from March to July in 2007.Patients were screened using Nutritional Risk Screening 2002(NRS2002)on admission and two weeks after admission(or discharge).The nutritional supper apphcation during hospital stay was recorded.NRS2002 score≥3 was classified as nutritional risk.BMI<1 8.5kg/m2 with impaired genend condition was defined as undemutrition.Results Among 300 enrolled patients,the NRS2002 WaS completed by 99.0%(297/300)of all patients.The nutritional risk and the prevalence of under_nutrition,overweight,and obesity was 30.0%,8.1%,38.3%,and 9.4%,respectively at admission.Fifty of 90(62.2%)patients who were at nutritional risk received nutritional support while 40 of 210(19.O%)non-risk patients received nutritional support.Especially among major abdominal surgery patients,56 of 90(71.6%)pa-tients who were at nutritional risk received nutritional supper while 35 of 81(43.2%)non-risk pafients received nutritional support.The prevalence of nutritional risk changed from 30.0%to 35.8%(X2=2.271,P=0.132).Conclusions NRS2002 is a feasible nutritional risk screening tool among general surgical pafienm in selected Bei-jing teaching hospitals.Nutritional support is somehow inappropriately apphed in general surgical hospitalized pa-tients.The prevalence of nutritional risk remains unchanged in general surgical patients during hospitalization.