基于腹内压分级肠内营养护理方案的构建及应用  

Development and application of enteral nutrition protocol based on intra-abdominal pressure grading

作　　者：王梅梅 彭飞 乔安花 王银娥 周丙梅 李文放 Wang Meimei;Peng Fei;Qiao Anhua;Wang Yin′e;Zhou Bingmei;Li Wenfang(Department of Emergency Surgery,The First Affiliated Hospital of Bengbu Medical University,Bengbu 233000,China)

机构地区：[1]蚌埠医科大学第一附属医院急诊外科,安徽蚌埠233000 [2]苏州大学医学部护理学院 [3]上海长征医院护理处 [4]上海长征医院重症医学科

出　　处：《护理学杂志》2024年第11期114-118,共5页Journal of Nursing Science

基　　金：2022年上海申康医院发展中心急诊与危重病诊疗新技术培训项目(SHDC22022205)。

摘　　要：目的构建基于腹内压分级的肠内营养护理方案,评价临床应用效果。方法将2023年4-11月重症监护室住院的80例伴腹内高压重症患者按时间段分为两组各40例。对照组采用常规肠内营养护理;观察组采用基于腹内压分级的肠内营养护理方案。连续实施7 d后评价效果。结果观察组与对照组分别有37例、38例完成研究。观察组喂养不耐受发生率显著低于对照组,干预7 d后总蛋白、白蛋白、前白蛋白、血红蛋白水平显著高于对照组,达预期目标喂养量时间显著短于对照组(均P<0.05)。结论对ICU腹内高压重症患者实施基于腹内压分级的肠内营养护理方案,可降低喂养不耐受发生率,提高喂养有效率,改善患者营养状况。Objective To develop enteral nutrition(EN)protocol based on intra-abdominal pressure(IAP)grading and to evaluate the clinical effect.Methods Eighty critically ill patients with intra-abdominal hypertension admitted to the intensive care unit from April to November 2023 were assigned to two groups chronologically,with 40 in each group.The control group was given routine EN,while the intervention group received EN based on the IAP grading.The effect was evaluated after 7 consecutive days of intervention.Results Thirty-seven patients in the intervention group and 38 patients in the control group completed the study.The intervention group had significantly lower incidence of feeding intolerance,higher concentrations of total protein,albumin,prealbumin,and hemoglobin,as well as shorter time required to achieve target-feeding rate compared with the control group(all P<0.05).Conclusion EN guided by IAP grading for ICU patients with intra-abdominal hypertension can reduce the incidence of feeding into-lerance,enhance the feeding efficiency,and improve nutritional status of patients.

关 键 词：重症患者 腹内高压 重症监护室 腹内压分级 肠内营养 干预方案 重症护理 

分 类 号：R473.6[医药卫生—护理学] R459.3[医药卫生—临床医学]