Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China.
Nutrition. 2012 Oct;28(10):1022-7. doi: 10.1016/j.nut.2012.01.017. Epub 2012 Jun 5.
This multicenter, prospective cohort study evaluated the effect of preoperative nutritional support in abdominal surgical patients at nutritional risk as defined by the Nutritional Risk Screening Tool 2002 (NRS-2002).
A consecutive series of patients admitted for selective abdominal surgery in the Peking Union Medical College Hospital and the Beijing University Third Hospital in Beijing, China were recruited from March 2007 to July 2008. Data were collected on the nutritional risk screening (NRS-2002), the application of perioperative nutritional support, surgery, complications, and length of stay. A minimum of 7 d of parenteral nutrition or enteral nutrition before surgery was considered adequate preoperative nutritional support.
In total 1085 patients were recruited, and 512 of them were at nutritional risk. Of the 120 patients with an NRS score at least 5, the complication rate was significantly lower in the preoperative nutrition group compared with the control group (25.6% versus 50.6%, P = 0.008). The postoperative hospital stay was significantly shorter in the preoperative nutrition group than in the control group (13.7 ± 7.9 versus 17.9 ± 11.3 d, P = 0.018). Of the 392 patients with an NRS score from 3 to 4, the complication rate and the postoperative hospital stay were similar between patients with and those without preoperative nutritional support (P = 1.0 and 0.770, respectively).
This finding suggests that preoperative nutritional support is beneficial to patients with an NRS score at least 5 by lowering the complication rate.
本多中心前瞻性队列研究评估了术前营养支持对 NRS-2002 定义的有营养风险的腹部外科患者的影响。
2007 年 3 月至 2008 年 7 月，连续纳入北京协和医院和北京大学第三医院择期腹部手术患者。收集营养风险筛查（NRS-2002）、围手术期营养支持应用、手术、并发症和住院时间等数据。术前给予至少 7 天的肠外或肠内营养被认为是充足的术前营养支持。
共纳入 1085 例患者，其中 512 例存在营养风险。在 NRS 评分至少为 5 的 120 例患者中，术前营养组的并发症发生率明显低于对照组（25.6%比 50.6%，P=0.008）。术前营养组的术后住院时间明显短于对照组（13.7±7.9 比 17.9±11.3 d，P=0.018）。在 NRS 评分 3 至 4 的 392 例患者中，术前营养支持与无术前营养支持患者的并发症发生率和术后住院时间相似（P=1.0 和 0.770）。
该研究结果提示，术前营养支持对 NRS 评分至少为 5 的患者有益，可降低并发症发生率。
