ICU病人肠内营养不耐受危险因素的Meta分析  

Risk factors for enteral nutrition intolerance in critically ill patients:a Meta-analysis

作　　者：练鹏敏 范宏瑾 葛炜 LIAN Pengmin;FAN Hongjin;GE Wei(Zhejiang Industry Polytechnic College,Zhejiang 312000 China)

机构地区：[1]浙江工业职业技术学院,浙江312000 [2]浙江省妇产科医院

出　　处：《循证护理》2024年第6期1007-1012,共6页Chinese Evidence-Based Nursing

基　　金：2022年度浙江工业职业技术学院“专业学科一体化建设”科研项目,编号:XKC202223023。

摘　　要：目的:通过Meta分析探讨重症监护室(ICU)病人肠内营养不耐受的危险因素。方法:检索万方数据库(WanFang Database)、中国知网(CNKI)、维普数据库(VIP)、中国生物医学文献数据库(CBM)等中关于ICU病人肠内营养不耐受的文献,提取相关数据并应用RevMan 5.3软件进行Meta分析。结果:最终纳入20篇文献。Meta分析结果表明,腹内压[OR=3.53,95%CI(2.42,5.16),P<0.00001]、急性生理与慢性健康评分系统Ⅱ(APACHEⅡ)评分[OR=2.17,95%CI(1.26,3.74),P=0.005]、应用抑酸药物[OR=3.56,95%CI(1.32,9.58),P=0.01]、禁食时间>72 h[OR=2.06,95%CI(1.47,2.88),P<0.0001]、肠内营养实施天数[OR=4.00,95%CI(3.55,4.45),P<0.00001]、年龄[OR=2.05,95%CI(1.51,2.79,P<0.0001)]、应用抗生素[OR=5.89,95%CI(1.88,18.41),P=0.002]是ICU病人肠内营养不耐受的危险因素。结论:现有证据表明,腹内压、APACHEⅡ评分、应用抑酸药物、禁食时间>72 h、肠内营养实施天数、年龄、应用抗生素是肠内营养不耐受的危险因素,应结合危险因素加强肠内营养不耐受的预防性护理,降低营养不耐受发生率。Objective:To investigate the risk factors of enteral nutritional intolerance in intensive care unit(ICU)patients through Meta-analysis.Methods:Literature on enteral nutritional intolerance in ICU patients was reviewed from WanFang Database,CNKI,VIP and CBM.The relevant data were extracted and analyzed with RevMan 5.3 software.Results:A total of 20 articles were included.The results of Meta-analysis showed that intra-abdominal pressure(OR=3.53,95%CI 2.42-5.16,P<0.00001),APACHEⅡscore(OR=2.17,95%CI 1.26-3.74,P=0.005),application of acid-suppressive drugs(OR=3.56,95%CI 1.32-9.58,P=0.01),fasting time>72 h(OR=2.06,95%CI 1.47-2.88,P<0.0001),implementation days of enteral nutrition(OR=4.00,95%CI 3.55-4.45,P<0.00001),age(OR=2.05,95%CI 1.51-2.79,P<0.0001)and application of antibiotics(OR=5.89,95%CI 1.88-18.41,P=0.002)were risk factors for enteral nutrition intolerance.Conclusion:The available evidence shows that intra-abdominal pressure,APACHEⅡscore,application of acid-suppressive drugs,fasting time>72 h,implementation days of enteral nutrition,age,application of antibiotics are risk factors for enteral nutritional intolerance.Preventive nursing of enter al nutritional intolerance should be strengthened in combination with risk factors to reduce the incidence of nutritional intolerance.

关 键 词：肠内营养不耐受 重症监护室 危险因素 META分析 循证护理 

分 类 号：R473.5[医药卫生—护理学]