儿科营养风险筛查在重症肺炎患儿中的临床应用

Clinical Application of the Pediatric Nutritional Risk Screening in Children with Severe Pneumonia

摘要: 目的：对重症肺炎患儿入院时进行营养风险筛查，分析营养风险与重症肺炎临床指标的关系。方法：采用儿科营养筛查评分工具(PNSS)对190例重症肺炎患儿入院24小时内进行营养风险筛查，比较不同营养风险组的一般资料(性别构成、年龄、PEWS评分、营养不良发生率等)，探讨营养风险与临床结局和血液指标的关系。结果：PNSS评分显示：高营养风险组57例(30%)，中营养风险组106例(55.8%)，无营养风险组27例(14.2%)，其中婴幼儿的营养风险评分及高营养风险率均高于3岁以上组患儿(P < 0.05)。营养风险与营养不良存在相关性，高营养风险患儿的营养不良发生率(35.1%)明显高于无/中营养风险患儿(6.8%) (P < 0.05)。高营养风险组患儿入院时PEWS评分高于无/中营养风险的患儿(P < 0.05)。高营养风险组患儿住院天数及住院总费用高于无/中营养风险组(P < 0.05)。结论：重症肺炎患儿的营养风险不容忽视，特别是婴幼儿。重症肺炎患儿入院时同时存在高营养风险可影响其临床结局。应关注重症肺炎儿童的营养风险筛查，尽早给予合理的营养支持，从而降低营养风险，改善临床结局。

Abstract: Objective: To conduct nutritional risk screening for children with severe pneumonia upon admission and analyze the relationship between nutritional risk and clinical indicators of severe pneumonia. Methods: The Pediatric Nutritional Screening Score (PNSS) tool was used to screen for nutritional risk within 24 hours of admission for 190 children with severe pneumonia. General information (gender composition, age, PEWS score, the incidence of malnutrition, etc.) across different nutritional risk groups was compared, and the relationship between nutritional risk and clinical outcomes as well as blood indicators was explored. Results: According to the Pediatric Nutrition Screening Score (PNSS), 57 cases (30%) fell into the high nutritional risk group, 106 cases (55.8%) into the moderate nutritional risk group, and 27 cases (14.2%) into the no nutritional risk group. Notably, infants and young children exhibited higher nutritional risk scores and a higher prevalence of high nutritional risk compared to children older than 3 years (P < 0.05). A correlation was observed between nutritional risk and malnutrition, with a significantly higher incidence of malnutrition (35.1%) in children with high nutritional risk compared to those with no or moderate nutritional risk (6.8%) (P < 0.05). Furthermore, children in the high nutritional risk group had higher Pediatric Early Warning Scores (PEWS) upon admission than those in the no or moderate nutritional risk group (P < 0.05). Additionally, the high nutritional risk group had longer hospital stays and incurred higher total hospitalization costs compared to the no or moderate nutritional risk group (P < 0.05). Conclusions: The nutritional risk faced by children with severe pneumonia, particularly infants and toddlers, cannot be ignored. The presence of high nutritional risk upon admission significantly impacts their clinical outcomes. Therefore, it is crucial to focus on nutritional risk screening for children with severe pneumonia and provide timely and appropriate nutritional support to mitigate these risks and enhance their clinical outcomes.