基于前馈控制的早期肠内营养干预在重症患者中的应用  

Application of early enteral nutrition intervention based on feedforward control in critically ill patients

作　　者：李亚[1] 宋玉敏 刘乐乐 田玉霞[1] LI Ya;SONG Yu-min;LIU Le-le;TIAN Yu-xia(Department of Critical Care Medicine,the Fifth Affiliated Hospital of Zhengzhou University,Zhengzhou 450000,Henan,CHINA;Department of Infection Prevention and Control,the Fifth Affiliated Hospital of Zhengzhou University,Zhengzhou 450000,Henan,CHINA)

机构地区：[1]郑州大学第五附属医院重症医学科,河南郑州450000 [2]郑州大学第五附属医院感染防控科,河南郑州450000

出　　处：《海南医学》2023年第13期1938-1941,共4页Hainan Medical Journal

基　　金：河南省医学科技攻关计划联合共建项目(编号:LHGJ20200483)。

摘　　要：目的探讨基于前馈控制的早期肠内营养干预在重症患者中的应用效果。方法回顾性分析2021年6月至2022年6月入住郑州大学第五附属医院重症医学科的75例重症患者的临床资料,将2021年6月至2021年12月入住的30例作为对照组,2022年1月至2022年6月入住的45例作为观察组,所有患者均接受肠内营养治疗,其中对照组患者接受常规干预,观察组患者接受前馈控制干预。比较两组患者干预第1天、第3天、第5天的能量摄入量,干预第3天、第5天、第7天的能量达标率,以及干预期间的胃潴留、呕吐、腹泻、腹胀等喂养不耐受发生情况。结果干预第3天、第5天,观察组患者的能量摄入量分别为(20.47±4.26)kCal/(kg·d)、(21.00±4.17)kCal/(kg·d),明显高于对照组的(18.14±5.68)kCal/(kg·d)、(19.11±3.42)kCal/(kg·d),差异均有统计学意义(P<0.05);干预第3天、第5天,观察组患者的能量达标率分别为66.67%、86.67%,明显高于对照组的43.33%、66.67%,差异均有统计学意义(P<0.05);观察组患者干预期间的腹胀、腹泻发生率分别为2.22%、6.67%,明显低于对照组的16.67%、23.33%,差异均有统计学意义(P<0.05)。结论基于前馈控制的早期肠内营养干预有助于减少喂养不耐受发生,保证肠内营养供给。Objective To explore the application effects of early enteral nutrition intervention based on feedfor-ward control in critically ill patients.Methods The clinical data of 75 critically ill patients admitted to Department of Critical Care Medicine,the Fifth Affiliated Hospital of Zhengzhou University from June 2021 to June 2022 were retro-spectively analyzed.Among the patients,30 cases admitted between June 2021 and December 2021 were selected as control group,and 45 cases admitted from January 2022 to June 2022 were included in observation group.All patients received enteral nutrition therapy.Patients in the control group received routine intervention,and patients in the obser-vation group were given feedforward control intervention.The energy intake on the 1st day,3rd day and 5th day of inter-vention,energy compliance rate on the 3rd day,5th day and 7th day of intervention,and occurrence of feeding intolerance such as gastric retention,vomiting,diarrhea and abdominal distention during intervention were compared between the two groups.Results On the 3rd day and 5th day of intervention,the energy intakes in the observation group were(20.47±4.26)kCal/(kg·d)and(21.00±4.17)kCal/(kg·d),which were significantly higher than(18.14±5.68)kCal/(kg·d)and(19.11±3.42)kCal/(kg·d)in the control group(P<0.05).The energy compliance rates in the observation group on the 3rd day and 5th day of intervention were 66.67%and 86.67%,which were significantly higher than 43.33%and 66.67%in the control group(P<0.05).The incidences of abdominal distension and diarrhea during intervention in the ob-servation group were 2.22%and 6.67%,respectively,which were significantly lower than 16.67%and 23.33%in the control group(P<0.05).Conclusion Early enteral nutrition intervention based on feedforward control can help to re-duce the occurrence of feeding intolerance and ensure the supply of enteral nutrition.

关 键 词：前馈控制 肠内营养 重症监护病房 喂养不耐受 营养风险 营养不良 

分 类 号：R473.5[医药卫生—护理学]