改良儿科营养风险筛查工具的临床应用

Clinical application of the modified pediatric nutritional risk screening tool

摘要:

目的 探讨改良儿科营养风险筛查工具及营养评估在临床中的应用，为建立儿科规范化营养管理流程提供理论依据。方法 回顾性分析16 249例住院患儿的入院营养风险筛查和营养评估资料，将患儿按营养风险程度分为高营养风险组（588例）、中营养风险组（4 330例）、无营养风险组（11 331例），对比各营养风险组患儿的营养评估情况，分析营养风险筛查的评分构成，以及营养风险筛查的开展对营养支持治疗率的影响。结果 营养风险发生率为30.27%（4 918/16 249），营养不良发生率为27.37%（4 448/16 249），营养过剩发生率为11.29%（1 834/16 249）。营养评估结果与营养风险程度均存在显著相关性（5岁及以上：r_s=0.313，P < 0.05；5岁以下：r_s=-0.304，P < 0.05）。不同营养风险组间，各评分项目的构成差异均有统计学意义（P < 0.05）。随着营养风险筛查的开展，患儿接受营养支持治疗率逐年上升（P < 0.05）。结论 住院患儿营养风险发生率较高，使用改良儿科营养风险筛查工具可促进规范化营养管理工作的开展。

Abstract:

Objective To study the clinical application of the modified nutritional risk screening tool and nutrition assessment in pediatric patients in China,and to provide a theoretical basis for establishing a standardized nutritional management process for pediatric patients.Methods A retrospective analysis was performed for the nutritional risk screening and nutrition assessment data of 16249 hospitalized children.According to the degree of nutritional risk,the children were divided into a high nutritional risk group with 588 children,a moderate nutritional risk group with 4330 children,and a non-nutritional risk group with 11331 children.Nutrition assessment results were compared between groups.The composition of nutritional risk screening scores and the impact of nutritional risk screening on the rate of nutrition support therapy were analyzed.Results The incidence rate of nutritional risk was 30.27%(4918/16249),and the incidence rates of malnutrition and overnutrition were 27.37%(4448/16249)and 11.29%(1834/16249),respectively.Nutrition assessment results were significantly correlated with nutritional risk(≥5 years old:rs=0.313,P<0.05;<5 years old:rs=-0.304,P<0.05).There was a significant difference in the composition of scoring items between the groups with different nutritional risks(P<0.05).With the implementation of nutritional risk screening,there was a gradual increase in the rate of nutrition support therapy year by year(P<0.05).Conclusions There is a high incidence rate of nutritional risk in hospitalized children.The use of the modified pediatric nutritional risk screening tool can promote the implementation of standardized nutritional management.