创伤严重程度和住院不同时间营养不良关系.docVIP

【摘要】 目的探讨创伤病人损伤严重程度与其住院不同时间营养不良的关系。方法对外伤后24 h内入院的120例创伤病人，入院首日依据创伤严重程度评分(ISS)分为轻度损伤、中度损伤及重度损伤，各40例。入院次日对病人进行营养不良风险筛查(NRS)，住院期间每周进行NRS评分，共4次。并对评分结果进行统计分析。结果ISS与住院期间第1～3周NRS评分呈正相关(r=0.408～0.752，P0.01)。重度损伤组第1～3周NRS评分明显高于其他两组，差异有显著性(F=11.16～121.28，q=2.15～21.15，P0.001)。结论创伤病人营养不良风险与创伤严重程度有关。对创伤病人进行ISS测定可预测病人住院期间不同时间存在营养不良的风险。 【关键词】 创伤和损伤;创伤严重度指数;营养不良 　[ABSTRACT]ObjectiveTo explore the relationship between malnutrition and severity of injury and at different time of hospital stay.MethodsOne hundred and twenty traumatic patients who admitted within 24 h of injury were included in this study. On the first day of admission, they were classified as minor, midrange and severe injury based on injury severity score (ISS), with 40 cases in each group. On the second day, the nutrition risk screening (NRS) was carried out with NRS 2000. The NRS was then conducted once a week for four times. The scores obtained were analyzed statistically.ResultsThe ISS was positively correlated with scores of NRS on week 1-3 of hospitalization (r=0.408-0.752,P0.01), those with severe injury, the score of NRS was higher than that of the other two groups, the differences being significant (F=11.16-121.28;q=2.15-21.15;P0.001).ConclusionThe risk of malnutrition is related to the severity of injury in traumatic patients. To grade the patients with ISS may predict the presence of malnutrition during different duration of their stay in hospital. 　　[KEY WORDS]wounds and injuries; injury severity index; malnutrition 　　创伤严重程度评分(ISS)是BAKER等[1]建立的一种创伤评分方法，用于评估创伤病人的损伤严重程度，对病人预后的评测价值已为国际所公认。营养不良风险筛查(NRS)[2]用于评估住院病人发生营养不良风险，预测病人临床结局，以指导营养干预。本研究对创伤病人的NRS评分进行分析总结, 旨在探讨创伤病人损伤严重程度与其住院不同时间营养不良间的关系。现将结果报告如下。 　　1资料和方法 　　1.1一般资料 　　创伤后24 h内入院病人120例，男118例,女2例;年龄19～48岁,平均34.4岁。致伤原因包括刀刺伤、高处坠落伤、车祸伤、重物挤压伤。病人近期内无其他严重疾病及外伤史。按照ISS[3]分为重度损伤(ISS≥25)、中度损伤(16≤ISS25)、轻度损伤组(ISS16)3组，3组病人ISS分别为(42.78±8.94)、(19.18±3.08)、(9.03±2.86)分。每组各40例病人。3组病人年龄比较差异无显著性。 　　1.2NRS评分方法 　　病人入院次日进行首次NRS，评分内容包括：①BMI是否20.5;②近3个月是否有体质量下降;③过去1周是否有摄食减少;④是