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ENGLISH ABSTRACT
营养风险筛查和全球(营养)领导人发起的营养不良诊断(GLIM)第二、三步流程(共识2020)
中华医学会肠外肠内营养学分会
营养风险-不足-支持-结局-成本/效果多中心协作组
张献娜
蒋朱明
康维明
于康
伍晓汀
王怡
詹思延
路潜
潘宏铭
叶欣
作者及单位信息
·
DOI： 10.3760/cma.j.cn115822-20200824-00199
Nutritional risk screening and GLIM steps 2 and 3 for the diagnosis of malnutrition and severity of malnutrition( Consensus 2020)
Chinese Society for Parenteral
Enteral Nutrition(CSPEN)-Nutritional risk-Undernutrition-Support-Outcome-Cost/effectiveness(NUSOC)
Zhang Xianna
Jiang Zhuming
Kang Weiming
Yu Kang
Wu Xiaoding
Wang Yi
Zhang Siyan
Lu Qiang
Pan Hongming
Yi Xin
Authors Info & Affiliations
Chinese Society for Parenteral
Enteral Nutrition(CSPEN)-Nutritional risk-Undernutrition-Support-Outcome-Cost/effectiveness(NUSOC)
Zhang Xianna
Department of Pancreatic Surgery, Wuhan Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
Jiang Zhuming
Departments of General Surgery-Clinical Nutrition-Medical Record-Room, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China
Kang Weiming
Departments of General Surgery-Clinical Nutrition-Medical Record-Room, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China
Yu Kang
Departments of General Surgery-Clinical Nutrition-Medical Record-Room, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China
Wu Xiaoding
Department of Surgery, West China Hospital, Sichuan University, Chengdu 610041, China
Wang Yi
Departments of General Surgery-Clinical Nutrition-Medical Record-Room, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China
Zhang Siyan
Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China
Lu Qiang
School of Nursing, Peking University, Beijing 100191, China
Pan Hongming
Department of Medical Oncology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou 310016, China
Yi Xin
Departments of General Surgery-Clinical Nutrition-Medical Record-Room, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China
·
DOI： 10.3760/cma.j.cn115822-20200824-00199
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摘要

近10年来，欧美与中国的肠外肠内营养专业学会对于营养诊疗的基本步骤认知一致，即营养筛查、营养评定、营养干预(包括干预后监测)三个基本步骤。2018年9月，全球(营养)领导人发起的营养不良诊断标准共识(global leadership initiative on malnutrition, GLIM)在线发表；2019年1月在美国，同年2月在欧洲正式发表。GLIM中明确第一步骤是：经过所在国的前瞻性临床有效性验证的营养筛查工具，在中国将营养风险筛查2002评分(nutritional risk screening 2002，NRS2002)作为诊断营养不良的第一步骤。中华医学会肠外肠内营养学分会营养风险-不足-支持-结局-成本/效果多中心协作组于2019年7月第44次工作坊筹备会议上，专家组提出：关于NRS2002筛查阳性者需制订营养干预计划及人力资源允许时需使用GLIM第二、三步诊断营养不良和严重程度分级的流程问题进行讨论，并于2019年和2020年经过专家函询问卷、现场表决和线上讨论的三轮方式达成本共识。

营养风险筛查;NRS2002;营养不良;GLIM;营养不良诊断;DRG
ABSTRACT

In the past 10 years, American Society for Parenteral and Enteral Nutrition , European Society for Clinical Nutrition and Metabolism and Chinese Society for Parenteral and Enteral Nutrition have had the similar understanding of the basic steps of nutritional care, namely (nutritional screening-nutritional assessment and nutritional intervention, including post-intervention monitoring). The first step of Global Leadership Initiative on Malnutrition(GLIM)using prospective clinically efficacy validated nutrition screening tool in the country where it is located. Nutritional Risk Screening2002(NRS2002)has validated by correct method of prospective clinical efficacy studies in China. The expert group proposed that when NRS2002 screening positive, a nutritional intervention plan needs to be developed. If human resources permit, steps 2 and 3 of GLIM need to be used to diagnose malnutrition and the severity classification process.

Nutrition risk screening;NRS2002;Malnutrition;GLIM. Diagnosis of malnutrition;DRG;Consensus
Jiang Zhuming, E-mail: nc.defcaab.smacimimzgnaij
Lu qian, nc.defudabe.umjbnaiqul
Pan Hongming, E-mail: nc.defudabe.ujzgnimgnohnap
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引用本文

中华医学会肠外肠内营养学分会,营养风险-不足-支持-结局-成本/效果多中心协作组,张献娜,等. 营养风险筛查和全球(营养)领导人发起的营养不良诊断(GLIM)第二、三步流程(共识2020)[J]. 中华临床营养杂志,2020,28(04)：193-200.

DOI:10.3760/cma.j.cn115822-20200824-00199

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近10年来，美国、欧洲和中国肠外肠内营养学分会对于营养诊疗的基本步骤认知一致，即营养筛查、评定及干预(包括干预后监测)的三个基本步骤 [ 1 , 2 , 3 , 4 , 5 , 6 ]。2018年9月全球(营养)领导人对营养不良标准(global leadership initiative on malnutrition，GLIM)在线发表。2019年1月在美国，同年2月在欧洲正式发表 [ 7 , 8 ]在GLIM中明确第一步骤是：明确用经过所在国的前瞻性临床有效性验证的营养筛查工具。在中国经过前瞻性临床有效性验证的营养筛查工具，是营养风险筛查，并经过2019和2020年通过专家的函询问卷、现场表决和线上讨论的三轮方式达成本共识。
目前，临床各学科都在推个体化医疗，但与临床各科室情况不同的是：肠外肠内营养学科与其他科室的精准医疗及靶向治疗有距离。中华医学会肠外肠内营养学分会营养风险-不足-支持-结局-成本/效果多中心协作组(简称本协作组)的目标是分出哪些患者需要肠外肠内营养支持疗法，在合理应用前提下让患者受益。中国的诊断相关分组(diagnosis related groups，DRG)正在用采集大数据办法来完善制定，需要让大数据收集系统看到有代码的营养风险和营养不良的两个诊断名称，并要填写在出院病案首页。
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备注信息
A
蒋朱明，E-mail： nc.defcaab.smacimimzgnaij
B
路潜，E-mail： nc.defudabe.umjbnaiqul
C
潘宏铭，E-mail： nc.defudabe.ujzgnimgnohnap
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