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胸外科手术患者术前营养状况的评估。

The evaluation of preoperative nutritional status in patients undergoing thoracic surgery.

作者信息

Trufă D I, Arhire Lidia Iuliana, Niţă Otilia, Gherasim Andreea, Niţă G, Graur Mariana

出版信息

Rev Med Chir Soc Med Nat Iasi. 2014 Apr-Jun;118(2):514-9.

Abstract

AIM

The aim of this study was to assess the preoperative nutritional status of patients undergoing thoracic surgery using different nutritional tools.

MATERIAL AND METHOD

. We conducted a prospective study on a sample of 43 thoracic patients, including 23 with neoplasms and 20 with non-neoplastic pathology who underwent thoracic surgery procedures between July-September 2011, in the Thoracic Surgery Clinic in Iaşi. Weight and height were measured and body mass index (BMI) was calculated. WHO classification for BMI categories was used. Preoperative serum level of transthyretin (TTR) and demographic data (gender, age) were also assessed. All patients were examined by the Subjective Global Assessment (SGA) and the Nutritional Risk Screening 2002 (NRS 2002).

RESULTS

After performing SGA, 67.9% of the patients were well-nourished, 21.4% were moderately or suspected of being malnourished and 10.7% were severely malnourished. The level of TTR was significantly lower in the moderately or severely malnourished group, compared to those considered well-nourished. According to NRS-2002, 42.9% of the patients were considered at nutritional risk. The level of TTR of these patients was lower than the level of TTR of the patients without nutritional risk, but without statistical significance.

CONCLUSIONS

Subjective Global Assessment (SGA) and the Nutritional Risk Screening 2002 (NRS 2002) are useful in identifying patients with nutritional risk, so that appropriate nutritional management could be initialised even before surgery.

摘要

目的

本研究旨在使用不同的营养评估工具评估胸外科手术患者的术前营养状况。

材料与方法

我们对43例胸科患者进行了一项前瞻性研究,其中包括23例肿瘤患者和20例非肿瘤性病变患者,这些患者于2011年7月至9月在雅西胸外科诊所接受了胸外科手术。测量了体重和身高,并计算了体重指数(BMI)。采用世界卫生组织的BMI分类标准。还评估了术前血清转甲状腺素蛋白(TTR)水平和人口统计学数据(性别、年龄)。所有患者均接受了主观全面评定法(SGA)和营养风险筛查2002(NRS 2002)评估。

结果

进行SGA评估后,67.9%的患者营养良好,21.4%的患者中度或疑似营养不良,10.7%的患者严重营养不良。与营养良好的患者相比,中度或重度营养不良组的TTR水平显著降低。根据NRS-2002,42.9%的患者被认为存在营养风险。这些患者的TTR水平低于无营养风险患者的TTR水平,但无统计学意义。

结论

主观全面评定法(SGA)和营养风险筛查2002(NRS 2002)有助于识别有营养风险的患者,以便在手术前甚至更早开始进行适当的营养管理。

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