摘要
目的调查脑卒中患者营养风险筛查2002(NRS 2002)及营养不良(筛查阳性者用GLIM第2步)现患率(prevalence)横断面调查及营养干预(8分类)情况。方法按整群采样,横断面调查研究。用NRS 2002对2018年1月至2019年1月北京天坛医院血管神经病学病区脑出血、脑梗死、蛛网膜下腔出血患者进行营养风险筛查,调查营养风险现患率。对于营养不良现患率,分两个阶段进行调查。2018年1月至2019年1月用BMI<18.5伴一般情况差评定营养不良。2018年10月至2019年1月采用全球(营养)领导人发起的营养不良(GLIM)评定(诊断)标准,不包括全身肌肉量测定结果;并记录患者住院期间营养干预情况。结果按整群采样3个血管神经病区共计1532例患者登记在案,经入排标准核查,1036例患者入组。营养风险现患率为33.0%(342/1036);依据BMI指标和GLIM标准共识,营养不良现患率分别为0.9%(9/1036)和2.5%(10/393)。在有营养风险的342例患者中接受营养支持疗法的有112例,均应用管饲。其中,规范营养支持有29例,不规范营养支持81例,极不规范营养支持2例;无接受单纯糖电解质输液、口服营养补充(ONS)、口服营养制剂、复合营养干预病例;其余230例为进食医院膳食的患者。结论北京某三甲医院脑出血、脑梗死、蛛网膜下腔出血患者营养风险现患率较高,而营养不良现患率极低。有营养风险患者的营养支持比例比较低,接受规范营养支持的比例更低。规范的营养支持疗法对改善脑卒中患者临床结局的影响,有待今后的大样本高质量队列研究的结果。
Objective To investigate the prevalence of nutritional risk(NRS2002)and malnutrition in hospitalized stroke patient and their nutritional intervention.Methods The stroke patients admitted to three departments of vascular neurology ward including cerebral hemorrhage,cerebral infarction and subarachnoid hemorrhage in Beijing Tiantan Hospital from January 2018 to January 2019 were recruited using cluster sampling.Nutritional risk screening 2002(NRS 2002)was used to screen the nutritional risk of inpatients Malnutrition was assessed by criteria:(1)body mass index(BMI)<18.5 kg/m2 with poorer general condition from January 2018 to January 2019;(2)Global leadership initiative on malnutrition(GLIM)criteria were used except whole body muscle mass measurement from October 2018 to January 2019.The nutritional intervention for patients were closely observed during hospitalization.Results A total of 1532 patients were registered and 1036 patients were included in the final analysis considering the inclusion and exclusion criteria.The prevalence of nutritional risk was 33.0%(342/1036).The prevalence of malnutrition based on BMI and GLIM criteria was 0.9%(9/1036)and 2.5%(10/393)respectively.Among the 342 patients with nutritional risk,112 patients received nutritional support therapy by tube feeding,but only 29 patients received nutritional support that met guideline standards.81 patients received not standard nutritional support,and 2 patients received highly unregulated nutritional support.No patients received sugar and electrolyte infusion,oral nutritional supplements(ONS),oral nutritional agents and compound nutrition intervention.The other 230 patients took hospital diet.Conclusion The prevalence of nutritional risk in hospitalized patients with cerebral hemorrhage,cerebral infarction or subarachnoid hemorrhage was high,and the prevalence of malnutrition was extremely low.There was a low proportion of nutritional support.High quality of large sample cohort studies will be conducted to show whether reasonable application of
作者
郝春满
李小萌
李振水
许英霞
王李
冯蕾
李响
王杨
赵延延
张献娜
杨剑
李卓
蒋朱明
Hao Chunman;Li Xiaomeng;Li Zhenshui;Xu Yingxia;Wang Li;Feng Lei;Li Xiang;Wang Yang;Zhao Yanyan;Zhang Xianna;Yang Jian;Li Zhuo;Jiang Zhuming(Department of Clinical Nutrition,Beijing Tiantan Hospital,Capital Medical University,Beijing 100070,China;不详)
出处
《中华临床营养杂志》
CAS
CSCD
2019年第6期331-337,共7页
Chinese Journal of Clinical Nutrition
关键词
脑出血
脑梗死
蛛网膜下腔出血
营养风险现患率
营养不良现患率
营养干预分类
脑卒中
Cerebralhemorrhage
Cerebral infarction
Subarachnoid hemorrhage
Prevalence ofnutritional risk
Prevalence ofmalnutrition
Classification of nutritional intervention
Stroke
