目的應用營養(yǎng)風險篩查(NRS)2002方法對胃癌住院患者營養(yǎng)風險狀況、營養(yǎng)不良發(fā)生率和營養(yǎng)支持現(xiàn)狀進行調查。方法對2009年6月至2010年2月期間在我院胃腸外科中心住院的胃癌患者進行營養(yǎng)風險篩查。根據(jù)患者疾病嚴重程度、營養(yǎng)狀況〔包括體重指數(shù)(BMI)、近期體重和進食情況〕及年齡3個方面,評定營養(yǎng)風險。NRS ≥3分為有營養(yǎng)風險,NRS lt;3分為無營養(yǎng)風險; BMI lt;18.5 kg/m2或白蛋白 lt;30 g/L并結合臨床情況判定是否營養(yǎng)不良(不足)。結果本研究共納入386例患者,其中329例成功完成篩查。有營養(yǎng)風險者165例(50.15%),無營養(yǎng)風險者164例(49.85%)。329例患者中營養(yǎng)不良者57例(17.33%); 按照性別: 231例男性胃癌患者中營養(yǎng)不良(不足)38例,所占比例為16.45%,有營養(yǎng)風險者111例,占48.05%; 98例女性胃癌患者中營養(yǎng)不良(不足)19例,所占比例為19.39%,有營養(yǎng)風險者54例,占55.10%。329例胃癌患者中有237例實施了臨床營養(yǎng)支持(72.04%),其中有營養(yǎng)風險患者165例中,實施臨床營養(yǎng)支持者115例(69.70%),無營養(yǎng)風險患者164例中實施臨床營養(yǎng)支持122例(74.39%)。結論目前胃癌住院患者營養(yǎng)不良發(fā)生率及有營養(yǎng)風險者比例均較高,并且臨床營養(yǎng)支持存在不合理性,這需要進一步推廣和應用基于證據(jù)的臨床營養(yǎng)支持指南以改善此狀況。
引用本文: 楊平,陳博,伍曉汀. 胃癌住院患者營養(yǎng)風險及臨床營養(yǎng)支持現(xiàn)狀調查. 中國普外基礎與臨床雜志, 2011, 18(6): 620-624. doi: 復制
版權信息: ?四川大學華西醫(yī)院華西期刊社《中國普外基礎與臨床雜志》版權所有,未經授權不得轉載、改編
1. | Kondrup J, Rasmussen HH, Hamberg O, et al; Ad Hoc ESPEN Working Group. Nutritional risk screening (NRS 2002): a new method based on an analysis of controlled clinical trials [J]. Clin Nutr, 2003, 22(3): 321336. |
2. | Gur AS, Atahan K, Aladag I, et al. The efficacy of Nutrition Risk Screening2002 (NRS2002) to decide on the nutritional support in general surgery patients [J]. Bratisl Lek Listy, 2009, 110(5): 290292. |
3. | Kondrup J, Allison SP, Elia M, et al. ESPEN Guidelines for nutrition screening 2002 [J], Clin Nutr, 2003, 22 (4): 415421. |
4. | Raslan M, Gonzalez MC, Dias MC, et al. Comparison of nutritional risk screening tools for predicting clinical outcomes in hospitalized patients [J]. Nutrition, 2010, 26(78): 721726. |
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)風險發(fā)生率及營養(yǎng)支持應用狀況調查 [J]. 中國臨床營養(yǎng)雜志, 2008, 16(6): 335337. |
6. | 蔣朱明, 于康, 朱賽楠, 等. 我國東中西部中小醫(yī)院住院患者營養(yǎng)不足、營養(yǎng)風險、超重和肥胖發(fā)生率及營養(yǎng)支持應用狀況調查 [J]. 中國臨床營養(yǎng)雜志, 2008, 16(6): 338340. |
7. | 中華人民共和國衛(wèi)生部疾病控制司. 中國成人超重和肥胖癥預防控制指南 [M]. 北京: 人民衛(wèi)生出版社, 2006: 146. |
8. | Bruce RS, Blackburn GI, Joseph Vitale, et al. Prevalence of malnutrition in general medical patients [J]. JAMA, 1976, 235(4): 15671570. |
9. | Twomey C, Briet F, Jeejeebhoy KN. Adeverse effect of malnutrition on lymphocyte mitochondrialcomplex I activity in humans [J]. Clin Nutr, 1994,18(1): 48. |
10. | van der Hulst RR, von Meyenfeldt MF, van Kreel BK, et al. Gut permeability, intestinal morphology, and nutritional depletion [J]. Nutrition, 1998, 14(1): 16. |
11. | 張明鳴, 周勇, 伍曉汀. 生長激素短期應用對胃腸外科手術后患者營養(yǎng)狀況和血清IGF1的影響 [J]. 中國普外基礎與臨床雜志, 2009, 16(12): 968973. |
12. | Schwegler I, von Holzen A, Gutzwiller JP, et al. Nutritional risk is a clinical predictor of postoperative mortality and morbidity in surgery for colorectal cancer [J]. Br J Surg, 2010, 97(1): 9297. |
13. | Burden ST, Hill J, Shaffer JL, et al. Nutritional status of preoperative colorectal cancer patients [J]. J Hum Nutr Diet, 2010, 23(4): 402407. |
14. | Caccialanza R, Klersy C, Cereda E, et al. Nutritional parameters associated with prolonged hospital stay among ambulatory adult patients [J]. CMAJ, 2010, 182(17): 18431849. |
15. | Schiesser M, Müller S, Kirchhoff P, et al. Assessment of a novel screening score for nutritional risk in predicting complications in gastrointestinal surgery [J]. Clin Nutr, 2008, 27(4): 565570. |
16. | 袁琮韋華, 李俊生, 嵇振嶺, 等. 全腸外營養(yǎng)及早期腸內營養(yǎng)在胃癌全胃切除術后患者中的對比研究 [J]. 中國普外基礎與臨床雜志, 2010, 17(4): 357362. |
17. | 中華醫(yī)學會. 住院患者營養(yǎng)風險篩查. 臨床診療指南腸外腸內營養(yǎng)學分冊(2008版) [M]. 北京: 人民衛(wèi)生出版社, 2009: 1620.. |
18. | Drescher T, Singler K, Ulrich A, et al. Comparison of two malnutrition risk screening methods (MNA and NRS 2002) and their association with markers of protein malnutrition in geriatric hospitalized patients [J]. Eur J Clin Nutr, 2010, 64(8): 887893. |
19. | Cardinal TR, Wazlawik E, Bastos JL, et al. Standardized phase angle indicates nutritional status in hospitalized preoperative patients [J]. Nutr Res, 2010, 30(9): 594600. |
20. | Bozzetti F, SCRINIO Working Group. Screening the nutritional status in oncology: a preliminary report on 1 000 outpatients [J]. Support Care Cancer, 2009, 17(3): 279284. |
21. | 梁曉坤, 蔣朱明, Nolan MT, 等. 北京教學醫(yī)院普通外科住院患者營養(yǎng)風險、營養(yǎng)不足、超重、肥胖及營養(yǎng)支持狀況 [J]. 中華臨床營養(yǎng)雜志, 2009, 17(2): 7578.. |
22. | Guo W, Ou G, Li X, et al. Screening of the nutritional risk of patients with gastric carcinoma before operation by NRS 2002 and its relationship with postoperative results [J]. J Gastroenterol Hepatol, 2010, 25(4): 800803. |
23. | Zhang YX, Wang SR. Distribution of body mass index and the prevalence changes of overweight and obesity among adolescents in Shandong, China from 1985 to 2005 [J]. Ann Hum Biol, 2008, 35(5): 547555. |
24. | Jiang ZM, Chen W, Zhan WH, et al. Parenteral and enteral nutrition application in west, middle and east China: A multicenter investigation for 15 098 patients in 13 metropolitans using Nutritional Risk Screening 2002 tool [J]. Clin Nutr, 2007, 2(Suppl 2): 133134. |
25. | 崔麗英, 張樹田, 于康, 等. 北京大醫(yī)院住院患者營養(yǎng)風險、營養(yǎng)不良(不足)、超重和肥胖發(fā)生率及營養(yǎng)支持應用狀況 [J]. 中國臨床營養(yǎng)雜志, 2008, 16(6): 341345.. |
- 1. Kondrup J, Rasmussen HH, Hamberg O, et al; Ad Hoc ESPEN Working Group. Nutritional risk screening (NRS 2002): a new method based on an analysis of controlled clinical trials [J]. Clin Nutr, 2003, 22(3): 321336.
- 2. Gur AS, Atahan K, Aladag I, et al. The efficacy of Nutrition Risk Screening2002 (NRS2002) to decide on the nutritional support in general surgery patients [J]. Bratisl Lek Listy, 2009, 110(5): 290292.
- 3. Kondrup J, Allison SP, Elia M, et al. ESPEN Guidelines for nutrition screening 2002 [J], Clin Nutr, 2003, 22 (4): 415421.
- 4. Raslan M, Gonzalez MC, Dias MC, et al. Comparison of nutritional risk screening tools for predicting clinical outcomes in hospitalized patients [J]. Nutrition, 2010, 26(78): 721726.
- 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)風險發(fā)生率及營養(yǎng)支持應用狀況調查 [J]. 中國臨床營養(yǎng)雜志, 2008, 16(6): 335337.
- 6. 蔣朱明, 于康, 朱賽楠, 等. 我國東中西部中小醫(yī)院住院患者營養(yǎng)不足、營養(yǎng)風險、超重和肥胖發(fā)生率及營養(yǎng)支持應用狀況調查 [J]. 中國臨床營養(yǎng)雜志, 2008, 16(6): 338340.
- 7. 中華人民共和國衛(wèi)生部疾病控制司. 中國成人超重和肥胖癥預防控制指南 [M]. 北京: 人民衛(wèi)生出版社, 2006: 146.
- 8. Bruce RS, Blackburn GI, Joseph Vitale, et al. Prevalence of malnutrition in general medical patients [J]. JAMA, 1976, 235(4): 15671570.
- 9. Twomey C, Briet F, Jeejeebhoy KN. Adeverse effect of malnutrition on lymphocyte mitochondrialcomplex I activity in humans [J]. Clin Nutr, 1994,18(1): 48.
- 10. van der Hulst RR, von Meyenfeldt MF, van Kreel BK, et al. Gut permeability, intestinal morphology, and nutritional depletion [J]. Nutrition, 1998, 14(1): 16.
- 11. 張明鳴, 周勇, 伍曉汀. 生長激素短期應用對胃腸外科手術后患者營養(yǎng)狀況和血清IGF1的影響 [J]. 中國普外基礎與臨床雜志, 2009, 16(12): 968973.
- 12. Schwegler I, von Holzen A, Gutzwiller JP, et al. Nutritional risk is a clinical predictor of postoperative mortality and morbidity in surgery for colorectal cancer [J]. Br J Surg, 2010, 97(1): 9297.
- 13. Burden ST, Hill J, Shaffer JL, et al. Nutritional status of preoperative colorectal cancer patients [J]. J Hum Nutr Diet, 2010, 23(4): 402407.
- 14. Caccialanza R, Klersy C, Cereda E, et al. Nutritional parameters associated with prolonged hospital stay among ambulatory adult patients [J]. CMAJ, 2010, 182(17): 18431849.
- 15. Schiesser M, Müller S, Kirchhoff P, et al. Assessment of a novel screening score for nutritional risk in predicting complications in gastrointestinal surgery [J]. Clin Nutr, 2008, 27(4): 565570.
- 16. 袁琮韋華, 李俊生, 嵇振嶺, 等. 全腸外營養(yǎng)及早期腸內營養(yǎng)在胃癌全胃切除術后患者中的對比研究 [J]. 中國普外基礎與臨床雜志, 2010, 17(4): 357362.
- 17. 中華醫(yī)學會. 住院患者營養(yǎng)風險篩查. 臨床診療指南腸外腸內營養(yǎng)學分冊(2008版) [M]. 北京: 人民衛(wèi)生出版社, 2009: 1620..
- 18. Drescher T, Singler K, Ulrich A, et al. Comparison of two malnutrition risk screening methods (MNA and NRS 2002) and their association with markers of protein malnutrition in geriatric hospitalized patients [J]. Eur J Clin Nutr, 2010, 64(8): 887893.
- 19. Cardinal TR, Wazlawik E, Bastos JL, et al. Standardized phase angle indicates nutritional status in hospitalized preoperative patients [J]. Nutr Res, 2010, 30(9): 594600.
- 20. Bozzetti F, SCRINIO Working Group. Screening the nutritional status in oncology: a preliminary report on 1 000 outpatients [J]. Support Care Cancer, 2009, 17(3): 279284.
- 21. 梁曉坤, 蔣朱明, Nolan MT, 等. 北京教學醫(yī)院普通外科住院患者營養(yǎng)風險、營養(yǎng)不足、超重、肥胖及營養(yǎng)支持狀況 [J]. 中華臨床營養(yǎng)雜志, 2009, 17(2): 7578..
- 22. Guo W, Ou G, Li X, et al. Screening of the nutritional risk of patients with gastric carcinoma before operation by NRS 2002 and its relationship with postoperative results [J]. J Gastroenterol Hepatol, 2010, 25(4): 800803.
- 23. Zhang YX, Wang SR. Distribution of body mass index and the prevalence changes of overweight and obesity among adolescents in Shandong, China from 1985 to 2005 [J]. Ann Hum Biol, 2008, 35(5): 547555.
- 24. Jiang ZM, Chen W, Zhan WH, et al. Parenteral and enteral nutrition application in west, middle and east China: A multicenter investigation for 15 098 patients in 13 metropolitans using Nutritional Risk Screening 2002 tool [J]. Clin Nutr, 2007, 2(Suppl 2): 133134.
- 25. 崔麗英, 張樹田, 于康, 等. 北京大醫(yī)院住院患者營養(yǎng)風險、營養(yǎng)不良(不足)、超重和肥胖發(fā)生率及營養(yǎng)支持應用狀況 [J]. 中國臨床營養(yǎng)雜志, 2008, 16(6): 341345..