目的：探讨患者入院握力水平与住院时间的关系。方法选取2012年6月—2012年12月于首都医科大学附属北京友谊医院住院患者926例为研究对象，其中男532例，女394例；内科患者540例，外科患者386例。采用《营养风险筛查表（ NRS2002）》评价患者营养状况，测定患者优势手握力。根据研究对象握力测定结果，以不同性别、年龄段的第25百分位数和第75百分位数的入院握力为界值，分为低、中、高握力水平。以住院时间为“生存时间”，住院率为“生存率”，对不同科室、性别患者进行生存分析。结果单因素分析显示，不同科室男性患者住院时间比较，差异有统计学意义（ t＝-3.150，P＜0.05）。不同科室女性患者入院握力水平比较，差异有统计学意义（χ2＝10.437，P＜0.05）。生存分析显示，外科女性不同握力水平患者住院时间比较，差异无统计学意义（χ2＝1.027， P＝0.598）。内科女性不同握力水平患者住院时间比较，差异有统计学意义（χ2＝10.045，P＝0.007），其中，高、中握力水平患者住院时间与低握力水平患者比较，差异有统计学意义（ P＜0.016）。外科男性不同握力水平患者住院时间比较，差异有统计学意义（χ2＝8.484，P＝0.014），其中，高、中握力水平患者住院时间与低握力水平患者比较，差异有统计学意义（ P＜0.016）。内科男性不同握力水平患者住院时间比较，差异有统计学意义（χ2＝13.028，P＝0.001），其中，高握力水平患者住院时间与中、低握力水平患者比较，差异有统计学意义（ P＜0.016）。结论低握力水平可能延长患者的住院时间，尤以内科患者为著。%Objective To investigate the relationship between the hand strength of patients at admission and the length of hospital stay. Methods A total of 926 inpatients of Beijing Friendship Hospital from June to December in 2012 were enrolled. Among the subjects,532 were male and 394 were female;540 were from Department of Internal Medicine and 386 from Department of Surgery. NRS2002 scale was employed to assess the nutritional status of patients,and the hand strength of patients was also determined. In each gender and age,the 25 percentile and 75 percentile were determined as the dividing values,by which the hand strength was divided into three levels:low level,middle level and high level. The length of hospital stay was considered as the" survival time"and admission rate was considered as" survival rate". Then survival analyses were conducted on different departments and genders. Results Univarale analysis showed that,different departments were different( t = -3. 150,P<0. 05)in the length of stay of male patients. Different departments were different(χ2 =10. 437,P<0. 05)in the hand strength of female patients. Survival analysis showed that,in the Department of Surgery,female patients with different hand strengths were not significantly different(χ2 =1. 027,P=0. 598)in the length of hospital. In the Department of Internal Medicine,female patients with different hand strengths were significantly different(χ2 =10. 045,P =0. 007)in length of hospital,and the female patients with high and middle level hand strength were significantly different( P<0. 016 )from those with low level hand strength in length of hospital. In the Department of Surgery,the male patients with different hand strengths were significantly different(χ2 =8. 484,P=0. 014)in length of hospital,and the male patients with high and middle level of hand strength were significantly different(P <0. 016)from those with low level hand strength in length of hospital. In the Department of Internal Medicine,the male patients with different hand strengths were significantly different(χ2 =13. 028,P=0. 001)in length of hospital,and the male patients with high level of hand strength were significantly different(P<0. 016)from those with middle and low level of hand strength in length of hospital. Conclusion Low level hand strength may prolong patients′hospital stay,especially for patients in the Department of Internal Medicine.
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