【摘要】 目的 調(diào)查胃癌患者的營養(yǎng)風(fēng)險及營養(yǎng)支持應(yīng)用現(xiàn)狀。 方法 2009年9月-2010年1月，對某三甲醫(yī)院普外科收治的120例胃癌住院患者營養(yǎng)情況進(jìn)行營養(yǎng)風(fēng)險篩查2002（nutritional risk screening 2002，NRS 2002）評估，并就營養(yǎng)支持應(yīng)用方式進(jìn)行分析。 結(jié)果 所有患者中營養(yǎng)不足和營養(yǎng)風(fēng)險的發(fā)生率分別為11.7%和27.5%；在33例有營養(yǎng)風(fēng)險患者中，有26例（78.8％）接受了營養(yǎng)支持；在無營養(yǎng)風(fēng)險的87例患者中，有30例（34.5％）接受了營養(yǎng)支持。 結(jié)論 對有營養(yǎng)風(fēng)險的患者進(jìn)行必要的營養(yǎng)支持，對于減少患者住院期間感染性并發(fā)癥或其他不良臨床結(jié)局的發(fā)生有積極作用。NRS 2002的方法簡便，適用于胃癌患者的營養(yǎng)風(fēng)險篩查，但醫(yī)護(hù)人員需要進(jìn)一步加強(qiáng)對腸外、腸內(nèi)營養(yǎng)指南的認(rèn)識。
【Abstract】 Objective To investigate the clinical situation of nutritional risk screening for hospitalized patients with gastric cancer. Methods From September 2009 to January 2010, we applied nutrition risk screening 2002 (NRS 2002) to investigate the nutritional status of 120 hospitalized gastric cancer patients in the surgery department of a tertiary hospital, and analyzed the way of nutritional support for these patients. Results Among all the patients, the incidences of undernutrtion and nutritional risk were respectively 11.7% and 27.5%. Twenty-six out of the 33 nutritional risk patients received nutrition support, and 30 out of the 87 patients without nutritional risk received nutrition support. Conclusions Nutritional support for patients with nutritional risk is important in decreasing the occurrence of in-hospital infectious complications and other bad clinical outcomes. NRS 2002 is a simple and easy tool for predicting the nutrition risk in hospitalized gastric cancer patients, but the guideline of enteral nutrition and parenteral nutrition must be reinforced among doctors and nurses.
引用本文： 印義瓊,劉春娟,劉麗容,鐘靜,文曰. 胃癌患者營養(yǎng)風(fēng)險篩查臨床現(xiàn)狀調(diào)查及分析. 華西醫(yī)學(xué), 2011, 26(10): 1536-1538. doi: 復(fù)制
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| 2. | 印義瓊, 李卡, 陳增蓉. 老年腹部疾病病人的外科護(hù)理[J]. 華西醫(yī)學(xué), 2006, 21(3): 605-606. |
| 3. | Kondrup J, Rasmussen HH, Hamberg O, et al. Nutritional risk screening (NRS 2002): a new method based on an analysis of controlled clinical trials[J]. Clin Nutr, 2003, 22(3): 321-336. |
| 4. | Kondrup J, Allison SP, Elia M, et al. ESPEN guidelines for nutrition screening 2002[J]. Clin Nutr, 2003, 22(4): 415-421. |
| 5. | 蔣朱明, 陳偉, 朱賽楠, 等. 我國東中西部大城市三甲醫(yī)院營養(yǎng)不良(不足)、營養(yǎng)風(fēng)險發(fā)生率及營養(yǎng)支持應(yīng)用狀況調(diào)查[J]. 中國臨床營養(yǎng)雜志, 2008, 16(6): 335-337. |
| 6. | Jie B, Jiang ZM, Nolan MT, et al. Impact of nutritional support on clinical outcome in patients at nutritional risk: a multicenter, prospective cohort study in Baltimore and Beijing teaching hospitals [J]. Nutrition, 2010, 26(11-12): 1088-1093. |
| 7. | Schiesser M, Müller S, Kirchhoff P, et al. Assessment of a novel screening score for nutritional risk in predicting complications in gastro-intestinal surgery [J]. Clin Nutr, 2008, 27(4): 565-570. |
| 8. | 陳博, 伍曉汀. 住院患者營養(yǎng)風(fēng)險篩查[J]. 華西醫(yī)學(xué), 2011, 26(2): 114-117. |
| 9. | American Gastroenterological Association (AGA). American Gastroenterological Association medical position statement: parenteral nutrition[J]. Gastroenterology, 2001, 121(4): 966-969. |
| 10. | Lochs H, Allison SP, Meier R, et al. Introductory to the ESPEN guidelines on enteral nutrition: terminology, definitions and general topics[J]. Clin Nutr, 2006; 25(2): 180-186. |
| 11. | 中華醫(yī)學(xué)會. 臨床診療指南-腸外腸內(nèi)營養(yǎng)學(xué)分冊[M]. 北京: 人民衛(wèi)生出版社, 2007: 15-81. |
| 12. | 陳偉, 蔣朱明, 張永梅, 等. 歐洲營養(yǎng)風(fēng)險調(diào)查方法在中國住院患者的臨床可行性研究[J]. 中國臨床營養(yǎng)雜志, 2005, 13(3): 137-141. |
| 13. | The Veterans Affairs Total Parenteral Nutrition Cooperation Study Group. Perioperative total parenteral nutrition in surgical patients[J]. N Engl J Med, 1991, 325(8): 525-532. |
- 1. 吳國豪, 秦新裕. 胃癌患者的營養(yǎng)支持[J]. 中華醫(yī)學(xué)雜志, 2004, 84(3): 179-181.
- 2. 印義瓊, 李卡, 陳增蓉. 老年腹部疾病病人的外科護(hù)理[J]. 華西醫(yī)學(xué), 2006, 21(3): 605-606.
- 3. Kondrup J, Rasmussen HH, Hamberg O, et al. Nutritional risk screening (NRS 2002): a new method based on an analysis of controlled clinical trials[J]. Clin Nutr, 2003, 22(3): 321-336.
- 4. Kondrup J, Allison SP, Elia M, et al. ESPEN guidelines for nutrition screening 2002[J]. Clin Nutr, 2003, 22(4): 415-421.
- 5. 蔣朱明, 陳偉, 朱賽楠, 等. 我國東中西部大城市三甲醫(yī)院營養(yǎng)不良(不足)、營養(yǎng)風(fēng)險發(fā)生率及營養(yǎng)支持應(yīng)用狀況調(diào)查[J]. 中國臨床營養(yǎng)雜志, 2008, 16(6): 335-337.
- 6. Jie B, Jiang ZM, Nolan MT, et al. Impact of nutritional support on clinical outcome in patients at nutritional risk: a multicenter, prospective cohort study in Baltimore and Beijing teaching hospitals [J]. Nutrition, 2010, 26(11-12): 1088-1093.
- 7. Schiesser M, Müller S, Kirchhoff P, et al. Assessment of a novel screening score for nutritional risk in predicting complications in gastro-intestinal surgery [J]. Clin Nutr, 2008, 27(4): 565-570.
- 8. 陳博, 伍曉汀. 住院患者營養(yǎng)風(fēng)險篩查[J]. 華西醫(yī)學(xué), 2011, 26(2): 114-117.
- 9. American Gastroenterological Association (AGA). American Gastroenterological Association medical position statement: parenteral nutrition[J]. Gastroenterology, 2001, 121(4): 966-969.
- 10. Lochs H, Allison SP, Meier R, et al. Introductory to the ESPEN guidelines on enteral nutrition: terminology, definitions and general topics[J]. Clin Nutr, 2006; 25(2): 180-186.
- 11. 中華醫(yī)學(xué)會. 臨床診療指南-腸外腸內(nèi)營養(yǎng)學(xué)分冊[M]. 北京: 人民衛(wèi)生出版社, 2007: 15-81.
- 12. 陳偉, 蔣朱明, 張永梅, 等. 歐洲營養(yǎng)風(fēng)險調(diào)查方法在中國住院患者的臨床可行性研究[J]. 中國臨床營養(yǎng)雜志, 2005, 13(3): 137-141.
- 13. The Veterans Affairs Total Parenteral Nutrition Cooperation Study Group. Perioperative total parenteral nutrition in surgical patients[J]. N Engl J Med, 1991, 325(8): 525-532.