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目的通过分析北京大学第一医院消化内科住院患者的营养风险及营养支持使用状况,发现当今消化内科营养支持治疗的问题。方法采用定点连续采样的方法,对2014年12月-2015年12月在北京大学第一医院消化内科住院患者使用NRS2002进行连续营养风险筛查,记录患者住院期间营养支持使用情况,包括营养支持方式、热卡量、蛋白质入量以及使用天数。分析消化内科不同疾病患者的营养风险状况。结果连续筛查患者1 103例,共纳入符合标准患者786例。营养风险发生率为28.88%,营养支持率为32.44%。有营养风险、无营养风险患者营养支持率分别为67.40%、18.25%,差异有统计学意义(P<0.05)。老年患者、中青年患者营养风险发生率分别为30.00%、28.29%,差异无统计学意义(P>0.05)。不同疾病的营养风险发生率依次是结核(85.71%)、胰腺疾病(72.58%)、肠梗阻(62.50%)、缺血性肠病(53.33%)、消化道出血(50.79%)、胆道疾病(40.91%)、炎症性肠病(37.63%)。肠外营养(PE)支持169例,肠内营养(NE)支持93例,PN:EN为2:1。结论 2015年北京大学第一医院消化内科住院患者的营养风险发生率高,老年患者营养风险发生率与中青年患者无明显差别,营养支持既有忽视又有滥用现象,应继续推广营养风险理念,规范营养支持。
Objective To find out the problems of nutritional support and treatment in today ’s digestive medicine by analyzing the nutritional risk and nutritional support status of inpatients in the Department of Gastroenterology, Peking University First Hospital. Methods The continuous nutrition risk screening of patients with gastroenterology in Peking University First Hospital from December 2014 to December 2015 was conducted by using fixed-point continuous sampling. NRS2002 was used to record the nutritional support during hospitalization, including nutritional support , Calories, protein intake and the number of days. Analysis of nutritional risk in patients with different diseases of Gastroenterology. Results A total of 1 103 consecutive patients were screened and 786 patients were eligible. The incidence of nutritional risk was 28.88%, nutritional support rate was 32.44%. Nutritional risk, nutritional support patients without nutritional risk rates were 67.40%, 18.25%, the difference was statistically significant (P <0.05). The incidence of nutritional risk in elderly patients and middle-aged patients was 30.00% and 28.29% respectively, with no significant difference (P> 0.05). The incidence of nutritional risk of different diseases were tuberculosis (85.71%), pancreatic disease (72.58%), intestinal obstruction (62.50%), ischemic enteropathy (53.33%), gastrointestinal bleeding (50.79%), biliary disease 40.91%), inflammatory bowel disease (37.63%). 169 cases of parenteral nutrition (PE) support, 93 cases of enteral nutrition (NE) support, 2: 1 PN: EN. Conclusions The incidence of nutritional risk in inpatients of Department of Gastroenterology, Peking University First Hospital in 2015 is high. The incidence of nutritional risk in elderly patients is not significantly different from that in middle-aged and young patients. Nutritional support is both neglected and abused. Therefore, Regulate nutritional support.