706例外科住院患儿营养风险筛查及其临床意义

Nutritional risk screening and its clinical significance in 706 children hospitalized in the surgical department

摘要:

目的：探讨外科住院患儿的营养风险及其与临床结局的相关性，为临床营养管理提供科学依据。方法：应用营养状况和生长风险筛查工具（STRONG）对706例外科住院患儿进行营养风险筛查，同时记录住院期间患儿营养支持情况、感染性并发症发生率、住院时间、术后住院时间以及住院总费用等资料进行分析。结果：706例外科住院患儿中，有11.5%存在高度营养风险，46.0%为中度营养风险，42.5%为低度营养风险；先天性肥厚性幽门狭窄、肠梗阻、先天性心脏病患儿居高度营养风险发生率前3位；婴儿高度营养风险的发生率明显高于其他年龄段患儿（P<0.01）；81例高度营养风险患儿中有52例（64.2%）接受了肠外营养支持；高度营养风险患儿住院期间较低度营养风险患儿更容易出现体重丢失（P<0.05），其感染性并发症、住院时间、术后住院时间以及住院总费用均明显高于中、低度营养风险患儿（均P<0.01）。结论：外科住院患儿存在中、高度营养风险；营养风险评分对患儿临床结局存在影响；目前外科住院患儿的营养支持仍不规范，需推广住院儿童营养风险筛查并进行规范的营养支持。

Abstract:

OBJECTIVE: To investigate nutritional risk and its relationship with clinical outcome in children hospitalized in the surgical department, and to provide a scientific basis for clinical nutrition management. METHODS: Nutritional risk screening was performed on 706 children hospitalized in the surgical department using the Screening Tool for Risk on Nutritional Status and Growth. The data on nutritional support during hospitalization, incidence of infectious complications, length of hospital stay, post operative length of hospital stay and total hospital expenses were recorded. RESULTS: Of the 706 cases, 11.5% had high nutritional risk, 46.0% had moderate nutritional risk, and 42.5% had low nutritional risk. Congenital hypertrophic pyloric stenosis, intestinal obstruction and congenital heart disease were the three most common types of high nutritional risk. The incidence of high nutritional risk was significantly higher in infants than in other age groups (P<0.01). Fifty-two (64.2%) of the eighty-one children with high nutritional risk received parenteral nutrition. Children with high nutritional risk were significantly more likely to have weight loss than children with low nutritional risk (P<0.05). Children with high nutritional risk had significantly increased incidence of infectious complications, length of hospital stay, post operative length of hospital stay and total hospital expenses compared with those with moderate or low nutritional risk (P<0.01). CONCLUSIONS: Moderate or high nutritional risk is seen in children hospitalized in the surgical department. Nutritional risk score is correlated with clinical outcome. Nutritional support for these children is not yet properly provided. Nutritional risk screening and standard nutritional support should be widely applied among hospitalized children.