Lim Hee-Sook, Kim Hyung-Chul, Park Yoon-Hyung, Kim Soon-Kyung
Department of Clinical Nutrition, Soonchunhyang University Bucheon Hospital, Bucheon 14584, Korea. ; Department of Preventive Medicine, College of Medicine, Soonchunhyang University, Cheonan 31151, Korea.
Department of Surgery, College of Medicine, Soonchunhyang University Bucheon Hospital, Bucheon 14584, Korea.
Clin Nutr Res. 2015 Oct;4(4):242-9. doi: 10.7762/cnr.2015.4.4.242. Epub 2015 Oct 31.
Malnutrition is a common problem in patients with end-stage liver disease requiring liver transplantation. The aim of this study was to evaluate nutritional status by using nutritional screening tools [Nutritional Risk Screening (NRS) 2002, Malnutrition Universal Screening Tool (MUST) and Subjective Global Assessment (SGA)] in patients before and after liver transplantation. We analyzed medical record, blood test, nutrient intake and malnutrition rate just before transplantation and at discharge, and at 3, 6, 12 months after transplantation respectively. Initially 33 patients enrolled as study subjects and finally 28 patients completed the study. Nutrients intake such as energy, fiber, calcium, potassium, vitamin C, and folate were insufficient at 12 months after transplantation. The rates of malnutrition before transplantation were very high, reported at 81.8% for the NRS 2002, 87.9% for the MUST, and 84.8% for the SGA. By 12 months after operation, malnutrition rates reported at NRS, MUST and SGA had decreased to 6.1%, 10.7%, and 10.7%, respectively. Sensitivity was 87.1% for the NRS 2002, 82.0% for the MUST, and 92.0% for the SGA. Of these screening tools the SGA was the highest sensitive tool that predict the risk of mortality in malnutrition patients who received transplantation. Further studies on nutritional status of patients and proper tools for nutrition intervention are needed to provide adequate nutritional care for patients.
营养不良是需要肝移植的终末期肝病患者的常见问题。本研究的目的是通过使用营养筛查工具[营养风险筛查（NRS）2002、营养不良通用筛查工具（MUST）和主观全面评定法（SGA）]评估肝移植患者术前和术后的营养状况。我们分别分析了移植前、出院时以及移植后3、6、12个月的病历、血液检查、营养摄入和营养不良率。最初有33例患者登记为研究对象，最终有28例患者完成了研究。移植后12个月时，能量、纤维、钙、钾、维生素C和叶酸等营养物质的摄入量不足。移植前的营养不良率非常高，NRS 2002报告为81.8%，MUST报告为87.9%，SGA报告为84.8%。术后12个月时，NRS、MUST和SGA报告的营养不良率分别降至6.1%、10.7%和10.7%。NRS 2002的敏感度为87.1%，MUST为82.0%，SGA为92.0%。在这些筛查工具中，SGA是预测接受移植的营养不良患者死亡风险的最高敏感度工具。需要对患者的营养状况和合适的营养干预工具进行进一步研究，以便为患者提供充分的营养护理。
