摘要目的 比较营养不良评估筛查工具(STAMP)与营养风险及发育不良筛查工具(STRONGkids)在儿童消化系统疾病中的应用价值.方法 2014年6月至9月在湖南省儿童医院消化内科住院1 053例患儿中完成营养风险筛查789例,同时运用STAMP及STRONGkids营养风险筛查工具进行筛查,以世界卫生组织儿童生长发育标准2006版评估方法评价营养状态.收集资料:一般情况、体质量丢失、住院时间、院内感染发生、营养干预及完成表格时间等.结果 789例患儿男女比例为1.21∶1.00;年龄30 d～1岁266例(33.7％),＞1～3岁248例(31.4％),＞3 ～6岁181例(23.0％),＞6 ～ 15岁94例(11.9％).完成评估表格平均时间:STRONGkids(2.41 ±1.01)min,STAMP (2.70±1.39) min,二者比较差异有统计学意义(P＜0.05).筛查结果:STRONGkids高风险31.9％(252例),STAMP高风险29.2％(230例),二者具有很高的一致性(Kappa值为0.881).营养不良评估:重度营养不良3.9％(31例).临床结局:体质量下降≥5％有89例(11.3％),住院时间超过7 d 302例(38.3％),营养干预245例(31.1％),院内感染69例(8.7％),医疗纠纷2例(0.3％).STRONGkids对营养干预及院内感染发生的预测灵敏度为81.6％和79.1％,特异度为61.4％和62.5％,STAMP与前者比较稍低.结论 消化系统疾病住院患儿营养风险发生率为1/3左右,STAMP与STRONGkids对消化系统疾病患儿营养风险筛查灵敏度及有效性均较高,且具有一致性,操作相对简单,尤其是STRONGkids评估时间明显较短,有利于临床操作,实用价值高.

abstractsObjective To compare the clinical value of screen tool for assessing malnutrition of pediatrics (STAMP) and screen tool for risk of nutritional status and growth (STRONGkids) in children's digestive diseases.Methods Out of 1 053 inpatients in Department of Gastroenterology,Hunan Province Children's Hospital from June to September of 2014,nutritional risk screenings were conducted in 789 patients,meanwhile STAMP and STRONGkids were used to evaluate the nutritional risks,and malnutrition evaluation method of World Health Organization Growth standard(2006) was used to assess the nutritional status.Data collected:general condition,weight loss,length of hospital stay,infection in hospital,nutrition intervention,time of filling the form,and so on.Results All 789 patients were with a male to female ratio of 1.21 to 1.00.Age distribution was as follows:30 d-1 year old 266 cases (33.7％);＞ 1-3 years old 248 cases (31.4％);＞ 3-6 years old 181 cases (23.0％),＞ 6-15 years old 94 cases (11.9％).The average time of form-filling was (2.41 ± 1.01) min for STRONGkids and (2.70 ± 1.39) min for STAMP,respectively,and the difference was statistically significant (P ＜ 0.05).Assessment results:STRONGkids 252 cases (31.9％) at high risk,STAMP 230 cases (29.2％) at high risk.The Kappa value of consistency of the 2 tools was 0.881,showing an excellent consistency.The result of malnutrition assessment:31 cases (3.9％) with severe malnutrition.Clinical outcomes:89 cases (11.3％) with weight loss (≥5％),302 cases (38.3％) with hospitalization for more than 7 days,245 cases (31.1％) received nutritional interventions,69 cases (8.7％) were infected in hospital,and medical disputes arose in 2 cases (0.3％).The predictive sensitivity and the specificity of STRONGkids to the nutritional intervention was 81.6％ and 79.1％,61.4％ and 62.5％ respectively.Compared to the TRONGkids,the sensitivity and specificity of STAMP were lower.Conclusions The incidence rate of nutritional risk in child inpatients with digestive diseases was about 1/3.The sensitivity and effectiveness of both STAMP and STRONGkids in these patients are high and consistent,and both tools are user-friendly,in particular,STRONGkids' evaluation time is shorter than STAMP's,so it is beneficial to clinical application.