目的 探索微型营养评估简易法（MNA-SF）能否客观、正确地评估老年住院患者的营养状况以及对临床预后进行预测。 方法 选择2012年3月－4月四川大学华西医院新入院老年患者407例，平均年龄（75.4 ± 7.10）岁，以MNA-SF评估其营养状态并根据营养状态分为两组，随访至出院或住院第30 d，分析其营养状况与住院时间，住院费用，全身炎症反应综合征（SIRS），死亡等临床结局的相关性。 结果 营养不良者22.6%（92例），营养不良风险者31.9%（130例），营养状态良好者45.5%（185例）。其中34例营养不良者，18例营养不良风险者和4例营养良好者发生SIRS；另有11例营养不良者，7例营养不良风险者和1例营养良好者死亡。MNA-SF分值在0～7分的患者无论在发生SIRS还是临床不良结局方面显著高于分值为8～14分的患者（P＜0.05）。营养不良者住院时间为（14.6 ± 8.30）d，营养不良风险或营养良好者为（12.1 ± 7.99）d，差异具有统计学意义（P＜0.05）。 结论 MNA-SF是一可靠，简便易行，可以预测老年住院患者临床预后的营养评估工具。
目的 运用营养风险筛查2002工具对普外科患者进行营养风险状况和营养支持现状调查。 方法 对2011年3月－8月在普外科新入院的520例患者进行营养风险筛查，判定是否存在营养风险，同时用已纳入患者现有的临床营养支持状况，分析目前临床营养支持的合理性。 结果 476例（91.5%）患者完成筛查。有营养风险者156例（32.8%），无营养风险者320例（67.2%）。在有营养风险患者中，实施临床营养支持者有131例，占84.0%；无营养风险患者中，实施了营养支持者占40.3%。 结论 基层县级医院普外科入院患者营养风险发生率较高，并且临床营养支持合理性尚待改善。
ObjectiveTo explore the effect of full nutritional management pattern on perioperative nutritional status in patients with head and neck malignancies. MethodsSixty-four patients with head and neck cancer treated in our department between March 2012 and June 2013 were randomly divided into control group and study group with 32 in each. The control group received conventional dietary guidance, while patients in the study group were given full nutritional management. Nutritional Risk Screening Scale 2002 (NRS-2002) was used for nutrition screening and assessment before surgery (after admission) and after surgery (3 days after surgery). The study group received full nutritional support, along with nutrition-related physical examination and biochemical tests, and observation of postoperative complications, and hospital stay and costs were also observed. ResultsNutritional risk existed in 29.7%-48.4% of the head and neck cancer patients during various stages of the perioperative period. Through the full nutritional support, patients in the study group had a significantly lower risk than those in the control group (P<0.01). Body mass index, triceps skinfold thickness, mid-arm muscle circumference, prealbumin, and creatinine in the study group were significantly more improved compared with the control group (P<0.01). No significant difference was detected in blood urea and serum albumin between the two groups. Postoperative complications in the study group was significantly lower (P<0.05), and hospital stay and costs were significantly lower than the control group (P<0.001). ConclusionFull nutritional management pattern can significantly improve the perioperative nutritional status in head and neck cancer patients. Early detection of nutritional risk and malnutrition (foot) in the patients and carrying out normal and scientific nutrition intervention are helpful in the rehabilitation of these patients. We suggest that qualified hospitals should carry out the full nutritional management model managed by a Nutrition Support Team for patients with malignancies.
Objective To investigate the correlation between nutrition related blood biochemical indexes levels and Patient-Generated Subjective Global Assessment (PG-SGA) in preoperative nutritional assessment of patients with gastric cancer. Methods One hundred and seventeen gastric cancer patients who underwent surgery were enrolled in this study by the Department of Gastrointestinal Surgery of West China Hospital. Nutritional status of each patient was evaluated by PG-SGA, in the meantime, nutrition related blood biochemical indexes levels such as transferrin (TRF), prealbumin (PA), albumin (Alb), and hemoglobin (HGB) were measured by analysis of fasting venous blood, then take correlation analysis on the result. Results Eighty cases (68.4%) were in malnutrition (PG-SGA score≥4). The TRF, PA, Alb, and HGB in malnutrition patients were lower than those in non-malnutrition patients (PG-SGA score<4, n=37, P<0.05). The TRF, PA, Alb, and HGB levels of gastric cancer patients had significant negtive correlation with PG-SGA score, the correlation coefficients was –0.629, –0.545, –0.418, and –0.235, respectively (P<0.05). When the PG-SGA score was greater than or equal to 4 points, the optimum cutoff value for TRF, PA, Alb, and HGB was 2.31 g/L, 190.50 mg/L, 38.65 g/L, and 100.50 g/L, respectively (P<0.05). Conclusions The incidence of malnutrition is high in gastric cancer patients preoperatively. The TRF, PA, Alb, and HGB are significantly decreased in the patients with malnutrition, and these indicators has significant negtive correlation with PG-SGA score. The current study indicated that a gastric cancer patient might be in malnutrition when the biochemical levels are less than or equal to TRF 2.31 g/L, PA 190.50 mg/L, Alb 38.65 g/L, HGB 100.50 g/L, and sufficient attention should be paid when any of these occasions appear clinically. The combination of PG-SGA score and nutrition related blood biochemical indexes levels could provide a more accurate assessment of preoperative nutritional status, and the evidence of nutritional intervention for patients with gastric cancer.