营养支持对高营养风险患儿临床结局的影响

营养支持对高营养风险患儿临床结局的影响
谢琪;黄玲;李欣辉
【期刊名称】《临床儿科杂志》
【年(卷),期】2016(034)012
【摘要】Objective To explore the clinical outcomes of nutritional support in children with high nutritional risk. Methods Improved screening tool for the assessment of malnutrition in pediatrics (STAMP) was used to make nutritional risk score in 1296 cases of consecutively hospitalized patients, and to analysis the effects of nutrition support in clinical outcome. Results In these 1296 hospitalized patients, 379 cases had STAMP score ≥ 4 and the detection rate of high nutritional risk was 29 . 24 %. A total of 304 cases were included for further analysis, including 85 cases ( 27 . 96 %) of nutritional support, among whom there were 37 cases of parenteral nutrition (PN), 23 cases of enteral nutrition (EN), 25 cases of combined application of EN and PN. Per capita and daily mean support cost were statistically different among patients with EN, PN and combination of PN and EN (P all < 0.001), and EN had least cost. Compared with patients without nutrition support, the infection rate in patients with nutrition support were lower, but there was no statistic difference (P = 0.095); the treatment fee of infectious diseases in patients without nutrition support was higher than that of patients with nutrition support and the cost of antibiotics was higher as well, and there were statistic differences (P
all < 0.001). The hospitalization costs in patients without nutrition support were different from that in patients with EN, PN, and PN combined EN (P
all < 0.001), while the duration of hospital stays were the same (P = 0.213). Conclusions Improved STAMP is a simple and practical nutritional risk screening tool for pediatric patients; there are differences in the cost among different nutrition support methods. Nutritional support can effectively improve clinical outcomes, especially in reducing infection and reducing the cost for the treatment of infection.%目的：探讨营养支持对有高营养风险患儿临床结局的影响。

方法应用改良的儿科营养不良筛查评分法（STAMP），对连续入院的1296例患儿进行营养风险筛查评分，并分析营养支
持对临床结局的影响。

结果1296例住院患儿中，379例STAMP评分≥4分，高
营养风险检出率为29.24%。

304例患儿纳入进一步分析，其中85例（27.96%）有营养支持。

营养支持患儿中，37例肠外营养支持（PN），23例肠内营养支持（EN），25例PN和EN联合应用；EN、PN、PN和EN联合应用比较，人均和日均营养支持费用的差异有统计学意义（P均 < 0.001）；EN的人均和日均费用
均为最低。

与无营养支持患儿比较，营养支持患儿感染发生率有所降低，但差异无统计学意义（P = 0.095）；无营养支持患儿抗感染治疗费用高于有营养支持患儿，抗生素治疗费用也明显高于有营养支持患儿，差异均有统计学意义（P均
 < 0.001）。

无营养支持、EN、PN、PN+EN四组间住院费用差异有统计学意义（P = 0.003），而四组间住院时间差异无统计学意义（P = 0.213）。

结论改良的STAMP评分作为儿科患者营养风险筛查工具简单实用；不同的营养支持方式费用存在差异；营养支持可有效改善临床结局，特别是减少感染和降低抗感染治疗费用。

【总页数】5页(P919-923)
【作者】谢琪;黄玲;李欣辉
【作者单位】广西壮族自治区桂林市人民医院广西桂林 541001;广西壮族自治区桂林市人民医院广西桂林 541001;广西壮族自治区南溪山医院广西桂林 541002【正文语种】中文
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