老年重症患者肠内营养期间腹泻发生的危险因素分析  

Risk factors of diarrhea associated with enteral nutrition in elderly patients with severe disease

作　　者：史颜梅 周亚婷[2] 白琳[2] 张淑香[3] 

机构地区：[1]潍坊医学院护理学院,潍坊261053 [2]山东大学护理学院,济南250012 [3]山东省千佛山医院护理部,济南250014

出　　处：《中华现代护理杂志》2017年第5期646-649,共4页Chinese Journal of Modern Nursing

基　　金：2015年度山东省医药卫生科技发展计划（2015WS0239）

摘　　要：目的 探讨入住ICU的老年患者肠内营养期间腹泻发生的危险因素.方法 选取2015年7月—2016年5月入住山东省千佛山医院ICU接受肠内营养治疗的老年患者100例,按是否发生腹泻分为腹泻组（n=36）和对照组（n=64）,收集两组患者的BMI、APACHEⅡ评分、是否存在低蛋白血症、是否机械通气、是否使用抗生素、抗酸药、促动力药等信息,采用单因素与多因素Logistic回归筛选肠内营养期间老年患者腹泻发生的危险因素.结果 多因素Logistic回归分析结果证实老年患者肠内营养期间腹泻发生的最危险因素是肠内营养期间患者机械通气（OR=2.528,P＜0.05）和存在低蛋白血症（OR=4.184,P＜0.05）.结论 老年患者需评估血清蛋白含量,低蛋白血症患者要纠正低蛋白血症后再进行肠内营养;老年患者机械通气状态下进行肠内营养时要减慢滴速、减少剂量、间断输注.Objective To study the risk factors of diarrhea associated with enteral nutrition in elderly patients with severe disease.Method One hundred elderly patients with enteral nutrition from July 2015 to May 2016 were divided into two groups. 36 elderly patients were enrolled in the diarrhea group,while 64 elderly patients without diarrhea were allocated in the control group. Body mss index （BMI）,APACHEⅡscore, whether have hypoproteinemia and mechanical ventilation,whether use antibiotics,antiacids and prokinetics, etc. Information of patients were collected,and relevant data of patients in two groups were analyzed by logistic regression.Results The multivariate logistic regression analysis showed that the most dangerous factors of enteral nutrition associated with diarrhea in patients were hypoproteinemia and mechanical ventilation during enteral nutrition （OR=2.528,4.184;P〈0.05）.Conclusions The serum protein should be assessed before carrying out enteral nutrition in elderly patients in case the presence of hypoproteinemia. For elderly patients with mechanical ventilation,the speed of enteral nutrition should slow down,the dose should be reduced with intermittent infusion.

关 键 词：肠内营养 腹泻 重症监护室 老年患者 INTENSIVE CARE unit (ICU) 

分 类 号：R473.5[医药卫生—护理学]