创伤后肠内营养喂养不耐受的影响因素分析

发布时间：2019-05-29 09:27

【摘要】：目的:探讨导致入住ICU的创伤患者肠内营养(enteral nutrition,EN)喂养不耐受(feeding intolerance,FI)发生的危险因素。方法:对2013年7月~2015年7月期间入住某三甲医院ICU并实施EN的98例创伤患者的病历资料进行回顾,对EN耐受组与不耐受组患者的年龄、血清白蛋白、血糖、EN开始时间、ISS评分、APACHEⅡ评分、GCS评分以及颅脑损伤、多发伤、脊髓损伤、骨折、其他伤5种创伤类型进行单因素分析,并将单因素分析结果中P0.2的指标纳入Logistic回归分析。结果:单因素分析结果显示:血清白蛋白、血糖、EN开始时间、APACHEⅡ评分、GCS评分以及5种创伤类型之间差异有统计学意义(P0.05),ISS评分P=0.1080.2;Logistic回归分析结果显示:血清白蛋白(OR=0.171,P=0.007,95%CI=0.048~0.616)、血糖(OR=10.493,P=0.001,95%CI=2.534~43.448)、EN开始时间(OR=11.540,P=0.004,95%CI=2.205~60.392)、GCS评分(OR=0.136,P=0.034,95%CI=0.021~0.858)、APACHEⅡ评分(OR=4.361,P=0.037,95%CI=1.096~17.350)是引起创伤患者发生FI的独立危险因素;而5种创伤类型中,除其他伤外,多发伤、脊髓损伤、骨折的患者其FI的发生率与颅脑伤患者没有统计学差异。结论:患者的血清白蛋白和GCS评分越低、血糖和APACHEⅡ评分越高、EN开始时间越晚,其发生FI的风险也越大。
[Abstract]:Objective: to investigate the risk factors of enteral nutrition (enteral nutrition,EN) feeding intolerance (feeding intolerance,FI) in traumatic patients admitted to ICU. Methods: the medical records of 98 trauma patients admitted to ICU and EN in a third grade A hospital from July 2013 to July 2015 were reviewed. The age, serum albumin, blood glucose and EN start time of patients in EN tolerance group and non-tolerance group were analyzed. ISS score, Apache II score, GCS score and five trauma types of craniocerebral injury, multiple injury, spinal cord injury, fracture and other injuries were analyzed by univariate analysis, and the index of P0.2 in univariate analysis was included in Logistic regression analysis. Results: the results of univariate analysis showed that there were significant differences in serum albumin, blood glucose, EN start time, Apache II score, GCS score and five types of trauma (P < 0.05), ISS score P 鈮，

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