严重烧伤患者肠内营养不耐受的影响因素及与预后的相关性

发布时间：2019-04-22 10:19

【摘要】：目的探讨严重烧伤患者肠内营养不耐受的影响因素及与预后的相关性。方法收集62例严重烧伤患者的临床资料,根据患者对肠内营养耐受与否分为耐受组和不耐受组,比较两组的临床特征和预后,分析发生肠内营养不耐受的影响因素。结果 62例患者中,不耐受组37例(59.7%),耐受组25例(40.3%)。与耐受组比较,不耐受组热卡达标率和热氮比达标率均显著降低(P0.05),第28天前白蛋白水平显著降低(P0.05),而肺炎、感染性休克和多脏器功能障碍综合征的发生率均显著升高(P0.05),病死率显著升高(P0.05)。多因素logistic回归分析显示,烧伤总面积较大、高APACHEⅡ评分、低蛋白、使用升压药、手术次数多是烧伤患者发生肠内营养不耐受的独立危险因素。结论严重烧伤患者发生肠内营养不耐受的比例较高,肠内营养不耐受与患者营养不良、并发症和预后不佳有关。
[Abstract]:Objective to investigate the influential factors of enteral nutrition intolerance in patients with severe burn and its correlation with prognosis. Methods the clinical data of 62 patients with severe burn were collected and divided into tolerance group and intolerance group according to their tolerance to enteral nutrition. The clinical characteristics and prognosis of the two groups were compared and the influencing factors of enteral nutrition intolerance were analyzed. Results of the 62 patients, 37 (59.7%) were in intolerance group and 25 (40.3%) in tolerance group. Compared with the tolerance group, the heat-to-nitrogen ratio and the heat-to-nitrogen ratio in the intolerance group were significantly lower than those in the tolerance group (P0.05), and the albumin level before 28th day was significantly lower than that in the control group (P0.05), while pneumonia was significantly lower than that in the intolerance group. The incidence of septic shock and multiple organ dysfunction syndrome was significantly higher (P0.05) and mortality was significantly higher (P0.05). Multivariate logistic regression analysis showed that large total burn area, high APACHE 鈪，

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