老年重症监护室小切口胃癌患者肠内营养相关性腹泻的危险因素Logistic分析  

Analysis of the influencing factors of enteral nutrition related diarrhea in 300 elderly patients in multicenter intensive care unit

作　　者：姚远[1] 李景武[1] 赵辉[1] 张磊[1] 李翰嵩 YAO Yuan;LI Jing-wu;ZHAO Hui;ZHANG Lei;LI Han-song(Department of Gastroenterology,the Second Tangshan People's Hospital,063001 Tangshan,Hebei,China)

机构地区：[1]唐山市人民医院胃肠外二科,河北唐山063001

出　　处：《临床消化病杂志》2023年第4期307-310,共4页Chinese Journal of Clinical Gastroenterology

基　　金：2022年度河北医学科学研究课题计划(No:20220217)。

摘　　要：[目的]探讨老年患者肠内营养(EN)相关性腹泻的影响因素分析。[方法]选择接受EN治疗的ICU小切口胃癌患者300例作为研究对象。详细记录患者的统计学资料,分析其EN期间腹泻的发生情况及相关影响因素。[结果]300例中172例EN期间发生腹泻(腹泻组),发生率为57.33%,其中155例(90.12%)腹泻发生在EN后7 d内,136例(79.07%)持续腹泻时间1~3 d;128例未发生腹泻(未腹泻组)。经单因素分析结果显示,2组性别、年龄、ICU住院时间、低蛋白血症、置管方式、EN制剂稀释和使用肠道菌群药比较差异无统计学意义(P>0.05);2组EN前禁食、EN制剂输注速度、EN制剂日用量、口服钾制剂和抗生素使用时间比较差异有统计学意义(P<0.05)。将上述单因素分析差异具有统计学意义的纳入多因素Logistic回归分析显示,EN前禁食、EN制剂输注速度、EN制剂日用量、口服钾制剂和抗生素使用时间为影响ICU老年小切口胃癌患者EN期间腹泻的危险因素。[结论]ICU老年小切口胃癌患者EN期间腹泻发生率较高,且影响因素较多,尤其是EN前禁食、EN制剂输注速度快、EN制剂剂量大、口服钾制剂及使用广谱抗生素的高危人群,应针对性做好EN护理,以消除或降低腹泻的发生风险。[Objective]To explore the influencing factors of enteral nutrition(EN)related diarrhea in elderly patients in multi center intensive care unit(ICU).[Methods]According to whether diarrhea occurred during the treatment,300 ICU patients were divided into diarrhea group and non diarrhea group.The statistical data of patients were recorded in detail,and the incidence of diarrhea during EN was analyzed.[Results]Among the 300 ICU patients,172 had diarrhea during EN(57.33%),155(90.12%)had diarrhea within 7 days after EN,and 136(79.07%)had diarrhea lasting for 1-3 days.The results of single factor analysis showed that there were no significant differences between the two groups in gender,age,length of stay in ICU,hypoproteinemia,catheterization,EN preparation dilution and use of intestinal flora drugs(P>0.05).There were significant differences between the two groups in fasting state before EN,EN preparation infusion speed,EN preparation daily dosage,oral potassium preparation and antibiotic use time(P<0.05).The results showed that fasting before EN,infusion speed of EN preparation,daily dosage of EN preparation,implementation time of oral potassium preparation and use time of antibiotics were the risk factors of diarrhea during en in elderly patients in ICU.[Conclusion]The incidence of diarrhea in the elderly patients in ICU during en period is high,and there are many influencing factors,especially in the high-risk group of fasting before EN,fast infusion of EN preparation,high dosage of EN preparation,oral potassium preparation and broad-spectrum antibiotics,we should do well in EN nursing to eliminate or reduce the risk of diarrhea.

关 键 词：腹泻 肠内营养 影响因素 重症监护室 

分 类 号：R442.2[医药卫生—诊断学]