慢性胰腺炎病人营养风险筛查和危险因素分析

目的:探讨慢性胰腺炎(CP)病人营养风险和相关危险因素。方法:应用营养风险筛查2002(NRS 2002)回顾性筛查156例CP病人的营养风险,纳入14项可能影响CP病人营养风险的临床参数,并行单因素和多因素Logistic回归分析。结果:在156例病人中,营养风险病人的比例明显高于营养不良病人(44.9%vs25.6%,χ~2=12.64,P=0.000 4)。单因素分析显示,性别、是否合并糖尿病、内镜下或外科胰腺干预、使用胰酶替代治疗、是否合并焦虑抑郁状态、是否平素进食不充分、是否使用营养支持和3个月以上营养支持等7项因素与营养风险发生相关(P0.01)。多因素回归结果显示,合并焦虑抑郁状态、平素进食不充分、3个月以上营养支持等为CP病人营养风险发生的危险因素。结论:CP病人营养风险高,需早期心理干预、鼓励恰当进食和适时的肠外或肠内营养支持治疗。

Surveys of nutrition risk and risk factors in patients with chronic pancreatitis

Objective:To evaluate the nutritional risk and its risk factors in patients with chronic pancreatitis (CP).Methods:Using nutritional risk screening 2012,a retrospective study was performed to analyze nutritional risk in 156 CP patients.Conditional logistic regression model was applied to identify the risk factors from fourteen clinical features that potentially influen cenutritional risk.Results:Proportion of patients with nutritional risk was significantly higher than malnutrition patients (44.9％ vs 25.6％,x2 =12.64,P =0.000 4).Univariate analysis indicated the following seven factors,gender,concomitant diabetes mellitus,intervention by endoscope or surgery,pancreatic enzyme replacement therapy,anxiety depression,insufficient eating and nutritional support for less than 3 months were associated with higher nutritional risk in CP patients (P ＜ 0.01).The result of multivariate analysis showed that anxiety depression,insufficient eating and nutritional support for less than 3 months werethe risk factors for malnutrition CP patients.Conclusion:There are higher nutritional risks in CP patients and early psychotherapy,sufficient eating and timely parenteral or enteral nutrition support should be undertaken for patients with chronic pancreatitis.