危重症患者肠内营养治疗后管饲依赖症状发生现况及影响因素研究  

Study on the occurrencee and influencingg factors of feeding tube dependence symptoms in critically ill patients after enteral nutrition therapy

作　　者：杜金磊 聂臣聪[1] 雷玲[1] 叶群 赵洪祥[1] 张继权 张得月 彭古涛 DU Jinlei;NIE Chencong;LE Ling;YE Qun;ZHAO Hongxiang;ZHANG Jiquan;ZHANG Deyue;PENG Gutao(Intensive Care Medicine Department,Zigong Fourth People's Hospital,Zigong,643000,China;不详)

机构地区：[1]自贡市第四人民医院重症医学科,四川省自贡市643000 [2]浙江大学第二附属医院重症医学科 [3]德阳市人民医院重症医学科 [4]重庆大学附属涪陵医院神经外科

出　　处：《中华急危重症护理杂志》2024年第6期493-498,共6页Chinese Journal of Emergency and Critical Care Nursing

基　　金：自贡市卫生健康委员会科研课题(21zd010,22yb047);自贡市科技局重点科技计划项目(2022ZCYGY30,2023YKY10)。

摘　　要：目的多中心调查国内危重症患者肠内营养治疗后管饲依赖症状发生现况,并对其影响因素展开系统分析。方法于2023年7月10日—20日,采用横断面调查法,对四川省、浙江省、江苏省、贵州省、重庆市等8个省市、12所三级综合医院内行肠内营养治疗结束后的危重症患者,使用一般资料调查表、管饲依赖症状评估量表展开问卷调查。结果该次调查共回收问卷225份,有效问卷221份,有效回收率为98%。危重症患者肠内营养治疗后管饲依赖症状发生率为64%。多因素Logistic回归分析结果显示,合并系统功能障碍数量[OR=4.605,95%CI(1.831~11.581)]、镇静与(或)镇痛药物使用天数[OR=1.578,95%CI(1.031~2.416)]、管饲进食天数[OR=1.634,95%CI(1.139~2.345)]以及促胃动力药物使用天数[OR=1.908,95%CI(1.089~3.345)]是危重症患者肠内营养治疗后管饲依赖症状发生的独立危险因素。结论危重症患者肠内营养治疗后,管饲依赖症状发生率较高,医护人员须建立和完善适用于危重症患者肠内营养治疗后管饲依赖症状的预防及管理机制。Objective To investigate the occurrence of feeding tube dependence symptoms after enteral nutrition therapy in critically ill patients from multi-centers,and to conduct a systematic analysis of its influencing factors.Methods From July 10 to July 20,2023,a cross-sectional survey was used to conduct questionnaire survey among critically ill patients after enteral nutrition treatment in 12 tertiary general hospitals from 8 provinces and cities,including Sichuan Province,Zhejiang Province,Jiangsu Province,Guizhou Province and Chongqing and etc.The general data questionnaire and the Tube Feeding Dependence Symptom Assessment Scale were used.Results A total of 225 questionnaires were collected and 221 were valid,with an effective recovery rate of 98%.The incidence of tub-feeding dependence symptoms after enteral nutrition treatment in critically ill patients was 64%.The results of multiple factor regression analysis showed that the number of dysfunction system[0R=4.605,95%CI(1.831~11.581)],the days of sedation and/or analgesic drug use[0R=1.578,95%CI(1.031~2.416)],tube feeding days[0R=1.634,95%CI(1.139~2.345)]and the days of gastric dynamic drugs use[0R=1.908,95%CI(1.089~-3.345)]were the independent risk factors for the occurrence of tube feeding tube dependence symptoms after enteral nutrition treatment in critically ill patients.Conclusion The incidence of feeding tube dependence symptoms is high after the enteral nutrition therapy in critically ill patients.Healthcare personnel should establish and improve the prevention and management mechanism applicable to feeding tube dependence symptoms after enteral nutrition therapy in critically ill patients.

关 键 词：肠内营养 管饲依赖 发生现况 影响因素 危重症护理 

分 类 号：R473[医药卫生—护理学]