肿瘤重症患者不同渗透压肠内营养液配制安全性与耐受性研究  

Study for the safety and tolerability for the reparation of enteral nutrition Liquid of different osmotic pressure for severe tumor patients in ICU

作　　者：赵静[1] 李文莉[1] 迟园园[1] 王舒朗[1] 魏华[1] 

机构地区：[1]天津医科大学肿瘤医院重症监护科国家肿瘤临床医学研究中心天津市"肿瘤防治"重点实验室,天津300060

出　　处：《护士进修杂志》2015年第10期869-871,共3页Journal of Nurses Training

摘　　要：目的探讨肿瘤重症患者不同渗透压肠内营养液配制的安全性与患者的耐受性。方法选取2012年1月-2013年12月收治于ICU需肠内营养治疗的肿瘤重症患者335例,整以时间顺序分为2012年1-12月的原液组输注115例,2013年1-12月的稀释组输注120例。在评估胃肠道功能后,原液组直接输注原液;稀释组通过规范的稀释配制成不同渗透压剂型后进行输注。评价能全力稀释液的外观性状改变及输注8h及12h后检菌检测结果;比较两组患者对肠内营养治疗的耐受性。结果能全力稀释液的外观性状无改变;肠内营养稀释液输注8h后检菌阳性的共3例(4.76%),12h后检菌阳性的共2例(3.51%),培养阳性的5例患者均未出现腹泻等胃肠道症状;输注8h与12h后检菌阳性结果差异无统计学意义(P>0.05);两组患者对肠内营养治疗的耐受性比较中,稀释维组优于原液组(P<0.05)。结论制订肠内营养液配制规范,可以有效地减少污染,提高肿瘤重症患者对肠内营养治疗的耐受性,更好地发挥营养治疗的作用。Objective To study the safety and tolerability for the preparation of enteral nutrition liquid of different osmotic pressure for severe patients with tumor. Method A total of 335 severe patients with tumor required enteral nutrition therapy in intensive care unit （ICU） from January, 2012 to December, 2013 were recruited into the study. According to the inclusion and exclusion criteria, 115 subjects admitted from January to December of 2012 were assigned into control group and administered standard solution. 120 subjects admitted from January to December of 2013 were assigned into intervention group and administered dilute solution. Whole protein enteral nutrition preparations was applied for preparing solutions for both group. After evaluating patients＇ gastrointestinal function, whole protein enteral nutrition preparations were administered to the control group, while the same solutions were diluted to different osmotic pressure and, then administered to intervention group. The change in appearance of the nutrison fiber and the lab results of bacterial after 8 and 12 hours of administration were observed. Additionally, the tolerability of the two groups of the enternal nutrient solution was compared. Result The appearance of the Nutrison Fiber did not change. Three cases＇ （4.76%） lab results of bacterial after 8 hours administration were positive, and 2 cases （3.51%） were positive after 12 hours administration. 5 patients who had positive bacterial results did not have diarrhea or other gastrointestinal symptoms. There is no significant difference of bacterial results between 8 hours and 12 hours after administration （P〈0.05）. When comparing the tolerability of the enternal nutrient solution, The number of patients with diarrhea, nausea and vomiting, abdominal distension, and stomachache in the intervention group was significantly fewer that of the control group （P〈0.05）. Conclusion Establishing protocol for preparation of enternal nutrient solution can effectively reduce contaminatio

关 键 词：肿瘤重症患者 肠内营养液 渗透压 安全性 耐受性 护理 

分 类 号：R473.73[医药卫生—护理学] R459.3[医药卫生—临床医学]