The Screening And Analysis Of Nutritional Risk In352Cases Of Gastrointestinal Patients Received Operation

Objective:To summarize the occurrence of nutritional risk in gastrointestinal neoplasm patients, and to propose better clinical strategies on the evidences of evidence-based medicine.Methods:The statistical study was carried out on the data of352cases of surgery patients in the gi-surgical department of Shandong Provincial Hospital from Oct.2012to Feb.2013. Nutritional risk screening2002(NRS2002) was applied for the nutritional risk screening at admission. Several comparisons were performed to analysis the impact on prognosis from different incidence rate of nutritional risk different nutritional support rate and different ways to get supported.Results:The NRS2002,whose applicable rate was98.3%, was completely suitable for clinical application and the incidence of nutritional risk of overall hospital patients was25.72%.The "non-risk" patients who did not receive preoperative nutritional support had a lower rate of postoperative complications (14.66%vs35.00%, P4=0.018) and less postoperative hospital stay (15.25±5.37d vs17.72±5.31d, P4=0.023) than the ones with nutritional risk. Both of the rate of postoperative complications (16.95%vs35.00%, P2=0.043) and postoperative hospital stay (15.22±4.55d vs17.72±5.31d, P2=0.029) of the patients in the nutritional risk group are shortened through nutritional support. The patients in nutritional risk group had a lower level of preoperative ALB (36.72±4.02g/L vs39.37±5.31g/L, P3=0.000) than the ones with no nutritional risk, but there was no significance difference in prognosis (P3>0.05) between the two groups. Applying the enteral nutrition after operations in time could shorten the days of postoperative fasting (3.25±1.32d vs3.73±1.54d, P=0.027) and parenteral nutrition using (6.35±2.21d vs7.13±2.10d, P=0.007), with no more cost (47362.31±9594.22Yuan vs47031.58±8845.62Yuan, P=0.401).Prolonging the time of using postoperative PN received no significant improvements in prognosis, but larger cost of hospitalization (47385.32±8521.63Yuan vs49235±8374.52Yuan, P=0.049)..Conclusion:It is necessary to apply preoperative nutritional risk screening in surgery patients, and the patients with nutritional risk should promptly get nutrition support treatment. Rational application of nutritional support can improve the prognosis effectively.