腹腔感染患者肠内营养耐受性分析及护理  

Analysis and Nursing of Enteral Nutrition Tolerance in Intra-Abdominal Infection Patients

作　　者：葛世伟[1] 何先弟[2] 张爱琴[3] 叶向红[3] 刘云[3] 

机构地区：[1]蚌埠医学院护理学系,安徽蚌埠233030 [2]蚌埠医学院第一附属医院重症监护病房,安徽蚌埠233004 [3]南京军区南京总医院护理部,江苏南京210002

出　　处：《解放军护理杂志》2014年第17期30-33,66,共5页Nursing Journal of Chinese People's Liberation Army

基　　金：江苏省南京市科技发展计划项目(201201082)

摘　　要：目的分析腹腔感染患者经鼻空肠管行肠内营养的耐受性及其相关因素,并提出相应护理措施以提高患者的耐受性。方法便利抽样选择2012年1-10月入住南京军区南京总医院普通外科重症监护病房的腹腔感染行肠内营养患者67例,分析其经鼻空肠管行肠内营养的耐受性及相关因素。结果 67例患者中42例(占62.7%)能耐受肠内营养支持,25例(占37.3%)不能耐受肠内营养支持,经相应处理后有10例患者转为耐受肠内营养。Logistic多因素回归分析显示:急性生理功能和慢性健康(acute physiology and chronic health evaluationⅡ,APACHEⅡ)评分、序贯器官衰竭估计(sequential organ failure assessment,SOFA)评分、开始肠内营养的时间、腹内压(intra-abdominal pressure,IAP)等对腹腔感染患者肠内营养耐受性的影响具有统计学意义(均P<0.05)。结论腹腔感染患者经鼻空肠管行肠内营养耐受性总体良好,肠内营养支持的耐受性与APACHEⅡ评分、SOFA评分、开始肠内营养的时间、腹内压等因素相关。Objective To explore tolerance-related factors of enteral nutrition（EN）by nasojejunal（NJ） tube in intra-abdominal infection patients,and to provide several nursing interventions for improving the patients’tolerance.Methods 67 patients using EN with NJ tube in intra-abdominal infection were random-ly selected,to explore tolerance-related factors of EN.Results Among the 67 patients,42 patients（62.7%） could tolerate,25 patients（37.3%）couldn’t tolerate.After treatment 10 patients ’tolerance was fair.Multi-variate logistic regression analysis showed that Acute Physiology and Chronic Health Evaluation Ⅱ（APACHE Ⅱ）score,Sequential Organ Failure Assessment（SOFA）score ,the time of beginning EN and intra-abdominal pressure（IAP）were statistically significant for enteral nutrition tolerance in intra-abdomi-nal infection patients （all P＆lt;0.05）.Conclusion Patients’feeding with NJ tube was well-tolerated in intra-abdominal infection.The factors from patients as APACHE Ⅱ score,SOFA score,the time of beginning EN and intra-abdominal pressure were significantly correlated with tolerance.

关 键 词：腹腔感染 肠内营养 耐受性 影响因素 护理 

分 类 号：R473.6[医药卫生—护理学]