[1]陈艺虹,吕桂兰.不同营养评估工具在重症肾脏病中的应用价值分析[J].肠外与肠内营养杂志,2021,(04):242-246.[doi:10.16151/j.1007-810x.2021.04.011]
　CHEN Yi-hong,L? Gui-lan.Application value of nutritional assessment tools in critical care nephrology[J].PARENTERAL & ENTERAL NUTRITION,2021,(04):242-246.[doi:10.16151/j.1007-810x.2021.04.011]
点击复制

不同营养评估工具在重症肾脏病中的应用价值分析
分享到：

《肠外与肠内营养》杂志[ISSN:1007-810X/CN:32-1477/R]

卷:
期数:
2021年04期
页码:
242-246
栏目:
综述
出版日期:
2021-07-10

文章信息/Info

Title:
Application value of nutritional assessment tools in critical care nephrology
作者:
陈艺虹 1; 2; 吕桂兰2
1.南京大学医学院，江苏南京 210093；2.东部战区总医院国家肾脏疾病临床医学研究中心,江苏南京 210002
Author(s):
CHEN Yi-hong1; 2;  L? Gui-lan2
1. Nanjing University School of Medicine, Nanjing 210093, Jiangsu, China；2. National Clinical Research Center of Kidney Diseases, Jinling Hospital, Nanjing 210002, Jiangsu, China
关键词:
重症肾脏病 ; 营养评估 ; 营养不良 ; 急性肾损伤
Keywords:
Critical care nephrology;  Nutritional assessment;  Malnutrition;  Acute kidney injury
分类号:
R692，R459.3
DOI:
10.16151/j.1007-810x.2021.04.011
文献标志码:
A
摘要:
重症肾脏病是 20世纪 90年代提出的新兴概念，重症肾脏病病人营养不良发生率高，与死亡风险升高显著相关，因此早期评估重症肾脏病病人的营养状态至关重要。目前国内外开发了多种营养评估工具，而鲜有研究将其应用于重症肾脏病领域。本文通过分析重症肾脏病病人营养不良风险的相关因素，比较了常见营养评估工具在重症肾脏病领域应用的优势和局限性，并为临床选择合适的营养评估工具给出建议。
Abstract:
Critical care nephrology is a new concept proposed in the 1990s. Patients with severe kidney disease have a high incidence of malnutrition, which is significantly associated with an increased risk of death. Therefore, it is crucial to assess nutritional status of patients with severe kidney disease as soon as possible. Currently, a variety of nutritional assessment tools have been developed, but their application in the field of critical care nephrology is still in its infancy. Therefore, in view of the particularity of the patients, this paper compares the advantages and limitations of common nutritional assessment tools in the field of critical care nephrology and provides suggestions for the clinical selection of appropriate assessment tools.

参考文献/References:


[1] 任宏生 . 美国重症医学临床实践观察 . 肠外与肠内营养, 2020,27(1): 5-7.
[2] Lew CCH, Yandell R, Fraser RJL, et al. Association Between Malnutrition and Clinical Outcomes in the Intensive Care Unit: A Systematic Review. JPEN J Parenter Enteral Nutr, 2017, 41(5):744-758.
[3] 桂兰兰, 许书添, 何群鹏, 等 . 营养支持改善危重肾脏病患者营养状况的前瞻性研究 . 肾脏病与透析肾移植杂志, 2013, 22(3):207-212.
[4] 张绍果, 王雅洁, 石美霞, 等 . Nutric量表在危重症病人营养不良风险评估中的应用 . 循证护理, 2019, 5(5): 440-444.
[5] 程伟鹤, 刘华平 . 营养风险筛查工具在危重症患者中的应用现状 . 中国护理管理, 2016, 16(8): 1140-1143.
[6] Ronco C, Bellomo R. Critical care nephrology: the time has come. Nephrol Dial Transplant, 1998,13(2): 264-267.
[7] 黎磊石 . 连续性肾脏替代治疗与重症疾病的救治 . 肾脏病与透析肾移植杂志, 1999, 8(3): 205-206.
[8] 许书添, 李世军 . 急性肾损伤对远隔器官机体重要脏器功能的影响和治疗靶点 . 肾脏病与透析肾移植杂志 , 2018, 27(3):260-264.
[9] 董建华, 葛永纯 . 急性肾损伤与体外器官功能支持的交互作用 . 肾脏病与透析肾移植杂志, 2021, 30(1): 81-86.
[10] Johansen N, Kondrup J, Plum LM, et al. Effect of nutritional support on clinical outcome in patients at nutritional risk. Clin Nutr, 2004,23(4): 539-550.
[11] Taylor BE, McClave SA, Martindale RG. Guidelines for the provision and assessment of nutrition support therapy in the adult critically ill patient: society of critical care medicine (SCCM) and American society for parenteral and enteral nutrition (A. S. P. E.N.). Crit Care Med, 2016, 44(2): 390-438.
[12] Singer P, Blaser AR, Berger MM, et al. ESPEN guideline on clinical nutrition in the intensive care unit. Clin Nutr, 2019,38(1):48-79.
[13] 李 喆, 许书添, 胡伟新, 等 . 系统性红斑狼疮合并持续炎症-免疫抑制-分解代谢综合征 . 肾脏病与透析肾移植杂志, 2020,29(2): 101-107.
[14] 林 靖, 阿斯楞, 王婧超, 等 . Nutric评分与改良 Nutric评分在成人重症患者营养评估中的应用进展 . 临床和实验医学杂志,2020,19(15): 1674-1676.
[15] 马锋振, 李全奎 . 肾病综合征水肿伴胃肠道反应 54 例临床分析 . 滨州医学院学报, 2001,24(2): 148-149.
[16] 刘志红, 龚德华 . 组合式体外多器官功能支持治疗:危重病症救治 的 发 展 方 向 . 肾脏病与透析肾移植杂志 , 2011, 20(3):201-203.
[17] Westra WM, Kopple JD, Krediet RT. Dietary protein requirements and dialysate protein losses in chronic peritoneal dialysis patients. Perit Dial Int, 2007, 27(2): 192-195.
[18] Morgera S, Rockt?schel J, Haase M, et al. Intermittent high permeability hemofiltration in septic patients with acute renal failure. Intensive Care Med, 2003,29(11): 1989-1995.
[19] Villa G, Neri M, De Rosa S, et al. Albumin Loss and Citrate Load in Pre-Dilution High Cut-Off-CVVHDF with Regional Citrate (18 mmol/L) and High Cut-Off CVVHD with Systemic Heparin: An in vitro Study. Blood Purif, 2018,46(3): 205-213.
[20] 桂兰兰, 许书添, 何群鹏, 等 . 营养支持改善危重肾脏病患者营养状况的前瞻性研究 . 肾脏病与透析肾移植杂志, 2013,22(3):207-212.
[21] 蒋晶晶, 黄东辉, 欧凤荣 . 膳食因素与慢性肾脏病发病风险的研究进展 . 医学综述, 2021,27(1): 18-23.
[22] 李春国, 周 飞 . 营养管理与慢性肾脏病的关系研究进展 . 中国实用医药, 2020,15(12): 184-187.
[23] 张叙旻, 顾伟莉, 韩文军 . 危重病人对 ICU适应性的影响因素分析 . 中国实用护理杂志, 2004, 20(20): 68-69.
[24] 赵玲玲 . 住院危重患者早期肠内营养水平的相关因素研究 . 医药论坛杂志, 2020,41(9): 128-130.
[25] 雷颜瑛, 熊 钰 . 重症狼疮性肾炎行血液透析患者不良心理状态及护理研究进展 . 齐鲁护理杂志, 2017, 23(6): 54-56.
[26] 洪丽萍, 熊雯超, 孙 静 . AKI住院患者心理焦虑状态调查及心理护理 . 国际护理学杂志, 2017,36(17): 2405-2407.
[27] Bauer J, Capra S, Ferguson M. Use of the scored PatientGenerated Subjective Global Assessment (PG-SGA) as a nutrition assessment tool in patients with cancer. Eur J Clin Nutr,2002,56(8): 779-785.
[28] Kalantar-Zadeh K, Kopple JD, Block G, et al. A malnutritioninflammation score is correlated with morbidity and mortality in maintenance hemodialysis patients. Am J Kidney Dis, 2001, 38 (6): 1251-1263.
[29] 中华医学会 . 临床诊疗指南-肠外肠内营养学分册 . 北京: 人民卫生出版社, 2006: 15-16.
[30] Coltman A, Peterson S, Roehl K, et al. Use of 3 tools to assess nutrition risk in the intensive care unit. JPEN J Parenter Enteral Nutr, 2015,39(1): 28-33.
[31] Gonzalez MC, Bielemann RM, Kruschardt PP, et al. Complementarity of NUTRIC score and Subjective Global Assessment for predicting 28-day mortality in critically ill patients. Clin Nutr, 2019, 38(6): 2846-2850.
[32] Fouque D, Kalantar-Zadeh K, Kopple J, et al. A proposed nomenclature and diagnostic criteria for protein-energy wasting in acute and chronic kidney disease. Kidney Int, 2008, 73(4):391-398.
[33] 宋建新, 邢铭友, 吴春明, 等 . 慢性重症肝炎患者营养支持及疗效评价 . 营养学报, 2004, 26(2): 107-111.
[34] 周 莹, 顾惠芳, 谢琼虹, 等 . 主观综合性营养评估预测急性肾损伤患者的预后 . 中华肾脏病杂志, 2011, 27(8): 567-571.
[35] Sabatino A, Theilla M, Hellerman M, et al. Energy and Protein in Critically Ill Patients with AKI: A Prospective, Multicenter Observational Study Using Indirect Calorimetry and Protein Catabolic Rate. Nutrients, 2017,9(8): 802.
[36] Reis AMD, Fructhenicht AVG, Moreira LF. NUTRIC score use around the world: a systematic review. Rev Bras Ter Intensiva, 2019,31(3): 379-385.
[37] 李广罡, 张美燕, 孙 玥, 等 . 危重症营养风险评分在神经系统危重症病人中的应用 . 肠外与肠内营养, 2015,22(5): 261-263.
[38] 孙 乔, 张腾松, 关 纯, 等 . 不同营养评估工具在 ICU患者营养状况评估中的应用比较 . 中华危重病急救医学, 2020,32(1):72-77.
[39] Xia YA, Healy A, Kruger R. Developing and Validating a Renal Nutrition Screening Tool to Effectively Identify Undernutrition Risk Among Renal Inpatients. J Ren Nutr, 2016,26(5): 299-307.
[40] MacLaughlin HL, Twomey J, Saunt R, et al. The nutrition impact symptoms (NIS) score detects malnutrition risk in patients admitted to nephrology wards. J Hum Nutr Diet, 2018, 31(5):683-688.
[41] Green SM, Watson R. Nutritional screening and assessment tools for use by nurses: literature review. J Adv Nurs, 2005, 50(1):69-83.
[42] Detsky AS, Mclaughlin JR, Baker JP, et al. What is subjective global assessment of nutritional status?. JPEN J Parenter Enteral Nutr, 1987,11(1): 8-13.
[43] Kondrup J, Rasmussen HH, Hamberg O, et al. Nutritional risk screening (NRS 2002): a new method based on an analysis of controlled clinical trials. Clin Nutr, 2003,22(3): 321-336.
[44] Heyland DK, Dhaliwal R, Jiang X, et al. Identifying critically ill patients who benefit the most from nutrition therapy: the development and initial validation of a novel risk assessment tool. Crit Care, 2011,15(6): R268.
[45] Bauer JM, Vogl T, Wicklein S, et al. Comparison of the Mini Nutritional Assessment, Subjective Global Assessment, and Nutritional Risk Screening (NRS 2002) for nutritional screening and assessment in geriatric hospital patients. Z Gerontol Geriatr, 2005,38(5): 322-327.
[46] Malnutrition Advisory Group. A consistent and reliable tool for malnutrition screening. Nurs Times, 2003,99(46): 26-27.

相似文献/References:

[1]宋 霞 综述,吕桂兰 审校.老年营养风险指数在维持性血液透析病人营养评估 中的应用进展[J].肠外与肠内营养杂志,2018,(05):304.[doi:10.16151/j.1007-810x.2018.05.012]
　SONG Xia,L? Gui-lan.Current knowledge of Geriatric Nutritional Risk Index in nutritional assessment in patients receiving maintenance hemodialysis[J].PARENTERAL & ENTERAL NUTRITION,2018,(04):304.[doi:10.16151/j.1007-810x.2018.05.012]
[2]李春蕾,曾亚奇,张 萍,等.简略版PG-SGA(PG-SGA SF)对肝癌病人营养评估价值[J].肠外与肠内营养杂志,2019,(05):266.[doi:DOI : 10.16151/j.1007-810x.2019.05.003]
　LI Chun-lei,ZENG Ya-qi,ZHANG Ping,et al.The role of PG-SGA SF in evaluating the perioperative nutritional status of patients with liver cancer[J].PARENTERAL & ENTERAL NUTRITION,2019,(04):266.[doi:DOI : 10.16151/j.1007-810x.2019.05.003]
[3]蒋小芝,王华伟,赵浩天 综述,等.骨骼肌超声在急危重症病人营养状态 评估中的应用骨骼肌超声在急危重症病人营养状态[J].肠外与肠内营养杂志,2019,(06):372.[doi:10.16151/j.1007-810x.2019.06.012]
　JIANG Xiao-zhi,WANG Hua-wei,ZHAO Hao-tian reviewing,et al.Application of skeletal muscle ultoassound in the assessment of ntritional status of critical patients[J].PARENTERAL & ENTERAL NUTRITION,2019,(04):372.[doi:10.16151/j.1007-810x.2019.06.012]
[4]杨林华,刘颖斌.梗阻性黄疸围手术期营养支持策略[J].肠外与肠内营养杂志,2020,(05):257.[doi:10.16151/j.1007-810x.2020.04.001]
[5]李春蕾,董凤齐,董 杰,等.患者主观整体评估在肝癌肝切除术后并发症中的预测作用[J].肠外与肠内营养杂志,2020,(05):274.[doi:10.16151/j.1007-810x.2020.04.005]
　LI Chun-lei,Dong Feng-qi,DONG Jie,et al.Predictive power of PG-SGA for post-hepatectomy complications in liver cancer patients[J].PARENTERAL & ENTERAL NUTRITION,2020,(04):274.[doi:10.16151/j.1007-810x.2020.04.005]
[6]阿丽玛,杨 帆,徐毛冶,等.542例慢性呼吸系统疾病住院病人营养状况调查分析[J].肠外与肠内营养杂志,2021,(01):16.[doi:10.16151/j.1007-810x.2021.01.004]
　Alima,YANG Fan,XU Mao-ye,et al.Analysis of nutritional status of 542 hospitalized patients with chronic respiratory diseases[J].PARENTERAL & ENTERAL NUTRITION,2021,(04):16.[doi:10.16151/j.1007-810x.2021.01.004]
[7]黄梦玄,曹峻,姜靖滔,等.相位角评估喉癌病人营养状况可行性研究[J].肠外与肠内营养杂志,2021,(04):199.[doi:10.16151/j.1007-810x.2021.04.002]
　HUANG Meng-xuan,CAO Jun,JIANG Jing-tao,et al.A study of the feasibility of using phase angle to assess the nutritional status of patients with laryngeal cancer[J].PARENTERAL & ENTERAL NUTRITION,2021,(04):199.[doi:10.16151/j.1007-810x.2021.04.002]
[8]许红阳.肺移植围术期的营养支持[J].肠外与肠内营养杂志,2021,(06):321.[doi:10.16151/j.1007-810x.2021.06.001]
[9]翁 敏,代正燕,甘志明,等.消化系统恶性肿瘤住院病人营养状况与生活质量的相关性分析[J].肠外与肠内营养杂志,2021,(06):347.
　WENG Min,DAI Zheng-yan,GAN Zhi-ming,et al.The correlation between nutritional status and life quality of patients with digestive system cancer[J].PARENTERAL & ENTERAL NUTRITION,2021,(04):347.
[10]陈艺虹,姜明霞,王永红,等.重症肾脏病医护人员对营养风险筛查工具的认识及体验[J].肠外与肠内营养杂志,2022,(01):41.[doi:DOI : 10.16151/j.1007-810x.2022.01.008]
　CHEN Yi-hong,JIANG Ming-xia,WANG Yong-hong,et al.Analysis on understanding and experience of medical staff engaged in critical care nephrology towards nutritional risk screening tools[J].PARENTERAL & ENTERAL NUTRITION,2022,(04):41.[doi:DOI : 10.16151/j.1007-810x.2022.01.008]

备注/Memo

备注/Memo:
基金项目 ：东部战区总医院院管课题（2016027） 作者简介 ：陈艺虹，护理硕士研究生，主要从事临床肾脏病护理及血液净化护理。E-mail:sxcjs@foxmail.com 通讯作者 ：吕桂兰，E-mail:2271500539@qq.com
更新日期/Last Update: 1900-01-01