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中国防痨杂志 ›› 2015, Vol. 37 ›› Issue (3): 276-279.doi: 10.3969/j.issn.1000-6621.2015.03.011

• 论著 • 上一篇    下一篇

132例脊柱结核患者围手术期营养状况的调查分析

雷国华 马皎洁 王倩 曹艳华 王秀华   

  1. 101149 首都医科大学附属北京胸科医院骨科(雷国华、王倩、曹艳华),营养科(马皎洁),护理部(王秀华)
  • 收稿日期:2014-12-23 出版日期:2015-03-10 发布日期:2015-04-03
  • 通信作者: 王秀华 E-mail:wangxiuhua@yeah.net
  • 基金资助:

    北京市科技计划项目(D121100003012005)

The perioperative nutritional status survey of 132 cases of patients with spinal tuberculosis

LEI Guo-hua, MA Jiao-jie, WANG Qian, CAO Yan-hua, WANG Xiu-hua   

  1. Department of Orthopaedic, Beijing Chest Hospital, Capital Medical University, Beijing 101149, China
  • Received:2014-12-23 Online:2015-03-10 Published:2015-04-03
  • Contact: WANG Xiu-hua E-mail:wangxiuhua@yeah.net

摘要: 目的 了解脊柱结核患者围手术期营养状况,为以后对围手术期患者进行针对性营养干预提供理论依据。 方法 调查2014 年1—10 月在北京胸科医院骨科住院的脊柱结核患者132例,于患者入院后24 h内、术后第6 天及第13天对患者进行营养风险评估[采用营养风险筛查(2002)(nutrition risk screening, NRS2002)评估表],并于入院后次日及术后第1天、第6天及第13天早晨空腹抽静脉血查患者血红蛋白(Hb)、淋巴细胞比值(LY%)、淋巴细胞计数(LY)和血浆白蛋白(ALB)。用SPSS 17.0软件录入数据并进行统计学分析,对不同时间点的营养风险发生率的比较采用χ2检验,以P<0.05认为差异有统计学意义。用Friedman检验对不同时间点的营养评分及Hb、LY%、LY、ALB值进行K个相关样本的非参数检验,以P<0.05认为差异有统计学意义。 结果 筛查脊柱结核患者围手术期营养风险的发生率,术后第6天高达87.88%(116/132)。比较不同时间点的营养相关化验指标,术后第6天 Hb[(106.27±16.74)g/L]及ALB[(31.36±3.84)g/L]测值比其他时间点都低;入院次日、术后第1天、术后第13天的Hb测值为:(130.79±16.67)g/L,(113.88±15.57)g/L,(113.38±18.08)g/L;ALB数值为:(38.74±3.90)g/L,(31.47±3.55)g/L,(34.82±3.68)g/L。术后第6天与其他时间点Hb、ALB测值比较,差异有统计学意义(χ2值分别为60.151、63.951, P值均<0.001)。术后第1天 LY%为(9.83±4.84)%,LY(1.26±0.79)×109/L,比其他时间点都低。入院次日、术后第6天、术后第13天的LY%分别为:(23.59±8.37)%,(18.69±5.97)%,(21.50±6.78)%;LY分别为:(1.62±0.56)×109/L,(1.39±0.60)×109/L,(1.59±0.61)×109/L。术后第1天LY%、LY与其他时间点测值比较,差异有统计学意义(χ2值分别为:52.370、27.662,P值均<0.001)。 结论 脊柱结核围手术期患者存在较高的营养风险,患者术后1周内营养状况较差,应给予重点营养干预,以促进患者康复。

关键词: 结核, 脊柱/外科学, 围手术期, 营养状况, 营养调查

Abstract: Objective To understand perioperative nutritional status in patients with spinal tuberculosis, in order to provide targeted nutritional intervention. Methods One hundred and thirty-two cases of spinal tuberculosis patients hospitalized between Jan-Oct. 2014 in Beijing Chest hospital were investigated. Patients received nutrition risk assessments (nutrition risk screening, NRS2002) within the 24 hours admitted, and 6 days, 13 days after the operation respectively. Patients also received the blood check for red protein (Hb), and Lym (LY%), count of lymphocytes (LY) and albumin (ALB) in the next day of admission, the 1st day, 6th days and 13th days after the operation. SPSS 17.0 software was used for data entry and statistical analysis, χ2 test was used for comparison of the nutrition risk incidence in different points in time, P<0.05 is considered the statistically significant. Results The incidence of peri-operative nutritional risk was up to 87.88%(116/132)in the 6th postoperative day. To compare indicators of nutrition-related testing at different points, the 6th postoperative day, Hb((106.27±16.74) g/L) and ALB((31.36±3.84) g/L) measuring values are lower than any other time point; the Hb measurement was (130.79±16.67) g/L, (113.88±15.57) g/L, (113.38±18.08) g/L; ALB measurement was (38.74±3.90) g/L, (31.47±3.55) g/L and (34.82±3.68) g/L respectively in the 1st day after hospitalization, 1st and 13th postoperative day. Hb and ALB measurements in the 6th postoperative day was statistically significant different in comparison with other point in time, (χ2 values is 60.151, 63.951 respectively, P both are <0.001).In 1st postoperative day, the LY% measurement was (9.83±4.84)% and LY was (1.26±0.79)×109/L, lower than any other point in time. the LY% measurement was (23.59±8.37)% (18.69±5.97)% (21.50±6.78)% and LY measurement was (1.62±0.56)×109/L,(1.39±0.60)×109/L,(1.59±0.61)×109/L respectively in the next day of hospitalization, the 6th and 13th postoperative day. LY% value in the 1st postoperative day was statistically different with other time points (χ2 values are: 52.370, 27.662 respectively,P both are <0.001). Conclusion The perioperative patients of spinal tuberculosis have high nutritional risk. Patients have poor nutritional status within 1 week after surgery, therefore we should focus on nutritional interventions in order to promote recovery.

Key words: Tuberculosis, spinal/surgery, Perioperative period, Nutritional status, Nutrition surveys