ICU内科危重症患者肠内营养喂养不耐受情况及其影响因素分析  

Enteral nutritional feeding intolerance in ICU patients with clinical medical conditions and its influencing factors

作　　者：耿照静 殷文超 焦洪波 赵燕霞 GENG Zhaojing;YIN Wenchao;JIAO Hongbo;ZHAO Yanxia(ICU,Fengtai Hospital of Integrated Traditional Chinese and Western Medicine of Beijing City,Beijing 100072,China;Department of Internal Medicine,the Second Shunyi Hospital of Beijing City,Beijing101309,China)

机构地区：[1]北京市丰台中西医结合医院ICU,北京100072 [2]北京市顺义区第二医院内科,北京101309

出　　处：《中国现代医生》2022年第4期105-107,111,共4页China Modern Doctor

摘　　要：目的分析ICU内科危重症患者肠内营养喂养不耐受情况及其影响因素。方法回顾性分析2018年2月至2021年2月北京市丰台中西医结合医院ICU危重症患者884例,自行设计ICU内科危重症患者肠内营养喂养不耐受的流行病学调查表,单因素、多因素logistic回归分析内科危重症患者肠内营养喂养不耐受情况及其影响因素。结果ICU内科危重症患者884例中,肠内营养喂养不耐受352例,发生率为39.82%,其中不同年龄、肠内营养开始时间、APACHEⅡ评分、添加膳食纤维、机械通气、低白蛋白血症、应用促胃动力药、口服钾制剂、应用镇静剂、应用血管活性药物、应用抗生素种类患者的肠内营养喂养不耐受发生率之间比较,差异有统计学意义(P<0.001,P<0.05)。多因素logistic回归分析显示,ICU内科危重症患者肠内营养喂养不耐受影响因素包括肠内营养开始时间、APACHEⅡ评分、添加膳食纤维、机械通气、低白蛋白血症、应用促胃动力药、口服钾制剂、应用抗生素种类(P<0.05)。结论ICU内科危重症患者肠内营养喂养不耐受发生率较高,影响因素包括肠内营养开始时间、APACHEⅡ评分、添加膳食纤维、机械通气、低白蛋白血症、应用促胃动力药、口服钾制剂、应用抗生素种类。Objective To analyze the status and influencing factors of enteral nutritional feeding intolerance in ICU patients with critical medical conditions.Methods A retrospective study of 884 patients with critical medical conditions in ICU,Fengtai Hospital of Integrated Traditional Chinese and Western Medicine of Beijing City from February 2018 to February 2021 was analyzed.An epidemiological questionnaire for enteral nutritional feeding intolerance in ICU patients with clinical medical conditions was designed.The univariate and multivariate Logistic regression analyses were performed to analyse the enteral nutrition feeding intolerance in patients with critical medical conditions and its influencing factors.Results Among 884 patients with clinical medical conditions in ICU,352 patients were intolerant to enteral nutrition feeding,with an incidence of 39.82%.Among different ages,enteral nutrition start time,APACHEⅡscores,dietary fiber addition,mechanical ventilation,hypoalbuminemia,application of gastric stimulating agents,oral potassium preparation,application of sedatives,application of vascular active drugs,and application types of antibiotics in patients,statistically significant differences were observed in the incidence of enteral nutritional feeding intolerance(P<0.001,P<0.05).The multivariate Logistic regression analysis showed that the influencing factors of enteral nutrition intolerance in ICU patients with clinical medical conditions included the start time of enteral nutrition,APACHEⅡscore,dietary fiber addition,mechanical ventilation,hypoalbuminemia,application of gastric stimulating agents,oral potassium preparation,and type of antibiotics(P<0.05).Conclusion The incidence of intolerance to enteral nutrition in ICU patients with critical medical conditions is higher,and the influencing factors include the start time of enteral nutrition,APACHEⅡscore,dietary fiber addition,mechanical ventilation,hypoalbuminemia,application of gastric stimulating agents,oral potassium preparation,and type of antibiotic

关 键 词：内科危重症 肠内营养喂养不耐受 影响因素 单因素分析 多因素LOGISTIC回归分析 

分 类 号：R574.4[医药卫生—消化系统]