重症患者肠内营养喂养不耐受临床常用措施效果分析

发布时间：2018-06-02 13:50

本文选题：重症监护 + 肠内营养　；参考：《第三军医大学学报》2017年11期

【摘要】：目的观察分析临床常用医疗护理措施对减少重症患者肠内营养喂养不耐受发生的效果。方法观察并记录2016年3-10月入住大坪医院ICU并实施肠内营养的160例重症患者的相关资料,对最终符合标准的109例患者,在肠内营养开始时按照患者选择的营养液类型,是否早期(肠内营养开始时)采取导泻、灌肠、使用促胃动力药物,是否补充白蛋白、使用益生菌、添加谷氨酰胺、联合给予肠外营养进行二分类分组。先采用单因素分析,再将单因素分析结果中P0.1的指标纳入多因素Logistic回归模型进行分析。结果单因素分析显示:营养液类型、早期导泻、早期灌肠、早期使用促胃动力药物、补充白蛋白对减少喂养不耐发生的效果差异具有统计学意义(P0.05);多因素分析显示:选择整蛋白型营养液(OR=0.152,P=0.001,95%CI:0.052~0.446),早期使用促胃动力药(OR=0.197,P=0.015,95%CI:0.054~0.726),早期灌肠(OR=0.251,P=0.010,95%CI:0.088~0.718)是降低喂养不耐受发生率的独立保护因素。结论在重症患者肠内营养一开始,选用整蛋白型营养液(胰腺炎患者除外),采取早期使用促胃动力药物、早期灌肠能有效减少喂养不耐受的发生。
[Abstract]:Objective to observe and analyze the effect of common clinical nursing measures on reducing enteral feeding intolerance in severe patients. Methods the data of 160 severe patients admitted to Daping Hospital from March to October 2016 and enteral nutrition were observed and recorded. 109 patients who finally met the standard were treated according to the type of nutrient solution selected by the patients at the beginning of enteral nutrition. Whether early (at the beginning of enteral nutrition) take catharsis, enema, use of gastric motility drugs, whether to supplement albumin, use probiotics, add glutamine, combined with parenteral nutrition for two groups. First, the single factor analysis was used, and then the P0.1 index in the single factor analysis result was incorporated into the multivariate Logistic regression model. Results univariate analysis showed that the types of nutrient solution, early diarrhea, early enema, early use of gastric motility drugs, There were significant differences in the effect of albumin supplementation on reducing the incidence of feeding intolerance, and multivariate analysis showed that the selection of the whole protein nutrient solution, ORO 0.152, P0. 001, 95, CI: 0. 052 0. 446, early use of the gastric motility drug, 0. 197 P0. 197 P0. 01595 CIW 0.054 0. 726, early enema, 0. 251% Pu, 0. 251%, CI0. 088, 0. 718) were used to reduce the incidence of feeding intolerance. Rate of independent protection. Conclusion at the beginning of enteral nutrition in severe patients, it is effective to reduce the incidence of feeding intolerance by using enteral nutrition solution (with the exception of pancreatitis patients) and early use of gastric motility drugs.
【作者单位】：第三军医大学护理学院基础护理教研室;第三军医大学大坪医院野战外科研究所重症医学科;
【分类号】：R473

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