营养治疗与呼吸机相关性肺炎发生情况的关系研究  

Research on relationship between nutritional support and incidence of ventilator-associated pneumonia

作　　者：于洪涛[1] 李飞[1] 臧金萍[1] 王红军[1] 王敏[1] 贾金广 聂丽娟[1] 吴红科[1] 

机构地区：[1]郑州人民医院,郑州450003

出　　处：《内科急危重症杂志》2013年第6期353-355,共3页Journal of Critical Care In Internal Medicine

基　　金：河南省卫生厅豫卫科〔2011〕17号

摘　　要：目的：研究呼吸重症监护病房（RICU）营养治疗与呼吸机相关性肺炎（VAP）发生情况的关系.方法：将61例气管插管使用有创呼吸机患者分为VAP组和非VAP组.记录入院时白蛋白水平、APACHEⅡ评分、住RICU时间及合并症情况,第1～7天摄入热量以及供能方式.分析能量供给与VAP发生率的关系 结果：第1天完成总能量供给≥50％和＜50％的患者,发生VAP的比例分别是52.3％与11.8％,差异具有统计学意义（P ＜0.05）7d内完成总能量供给50％～100％患者发生VAP是32％（8/25）,而总能量供给＞100％的患者中发生VAP是61.5％（16/26）,具有统计学意义（P＜0.05）.Logistic回归显示：第1天完成＞100％能量供给和APACHEⅡ评分增加是VAP的危险因素（均P＜0.05） 7d内完成全肠内营养50％ ～ 100％能量供给是降低VAP发生风险的因素.结论：不同营养方式间,发生VAP的差异不显著.7d内完成总能量供给50％ ～ 100％有利于预防VAP的发生.Objective ： To research the relationship between nutritional support and the incidence of ventilator-associated pneumonia （VAP） in critically ill patients in respiratory intensive care unit （RICU）. Methods：Six-one cases with invasive ventilator were divided into VAP group and non-VAP group. Levels of albumin, APACHE Ⅱ score at admission, duration of RICU stay, complications, energy supply as well as the way of energy supply were recorded in the first to 7th days. The relationship between nutritional support and the incidence of VAP were analyzed. Results ： Among patients who have total energy supply greater than or equal to 50% and less than 50% in the first day, the incidence of VAP were 52.3% and 11.8% respectively, and there was significant difference （ P 〈 0.05 ） 50% - 100% within 7 days, the incidence of VAP was 32% Among patients who have completed the total energy supply （8/25）, while total energy supply greater than 100%, the incidence of VAP was 61.5% （16/26） （P 〈0.05）. Logistic regression analysis showed that the completion of 〉 100% of the energy supply at the first day and increased APACHE- Ⅱ score were the risk factor for VAP （P 〈 0.05）. Completion of the total enteral nutrition calories 50% - 100% may reduce the risk of VAP （ P 〈 0.05）. Conclusions ： There is no significant difference in the incidence of VAP among the different ways of nutritional support. Completion of the total energy supply up to 50% - 100% within seven days may help to prevent VAP.

关 键 词：呼吸重症监护病房 呼吸机相关性肺炎 肠内营养 肠外营养 

分 类 号：R563.1[医药卫生—呼吸系统]