营养不良患者再喂养综合征的危险因素分析  

Analysis of Risk Factors for Refeeding Syndrome in Malnourished Patients

作　　者：张聪聪[1] 李佳倩[1] 赵明曦 兰元梅 陈天超 冯悦颖 ZHANG Congcong;LI Jiaqian;ZHAO Mingxi;LAN Yuanmei;CHEN Tianchao;FENG Yueying(Department of Clinical Nutrition,Peking Union Medical College Hospital,Beijing,100730,China)

机构地区：[1]北京协和医院临床营养科,北京100730

出　　处：《中外医疗》2024年第29期37-40,共4页China & Foreign Medical Treatment

摘　　要：目的分析营养不良患者再喂养综合征的危险因素。方法回顾性选取2020年6月—2023年5月北京协和医院收治的104例营养不良患者的临床资料,根据患者再喂养综合征发生情况分为再喂养综合征组(35例)与非再喂养综合征组(69例)。采用单因素分析、多因素分析营养不良患者再喂养综合征的影响因素。结果经单因素分析,两组性别、喂养前胃肠减压、喂养前使用胰岛素、喂养前使用抑酸剂、喂养前使用利尿剂对比,差异无统计学意义(P均>0.05);两组年龄、体重指数、营养风险评估量表2002(Nutritional Risk Screen⁃ing,NRS 2002)、急性生理与慢性健康状况评分(Acute Physiology and Chronic Health EvaluationⅡ,APACHEⅡ)、营养液类型、肠内营养液温度对比,差异有统计学意义(P均<0.05)。经多因素分析,年龄≥55岁、体重指数≥20.5 kg/m^(2)、NRS 2002评分6~7分、APACHEⅡ评分≥20分、使用短肽型营养液、肠内营养液温度36~38℃是营养不良患者再喂养综合征的独立危险因素(OR=2.208、2.230、2.277、2.277、2.140、2.358,P均<0.05)。结论年龄≥55岁、体重指数≥20.5 kg/m^(2)、NRS 2002评分6~7分、APACHEⅡ评分≥20分、使用短肽型营养液、肠内营养液温度36~38℃是营养不良患者再喂养综合征的独立危险因素。因此,在患者临床干预中需加强患者喂养情况的监测,加强喂养护理和营养支持,加强相关影响因素的控制和管理。Objective To analyze the risk factors of refeeding syndrome in malnourished patients.Methods The clini⁃cal data of 104 patients with malnutrition admitted to Peking Union Medical College Hospital from June 2020 to May 2023 were retrospectively selected.According to the occurrence of refeeding syndrome,the patients were divided into refeeding syndrome group(35 cases)and non-refeeding syndrome group(69 cases).Univariate analysis and multivari⁃ate analysis were used to analyze influencing factors of refeeding syndrome in malnourished patients.Results By uni⁃variate analysis,there was no significant difference in gender,gastrointestinal decompression before feeding,insulin use before feeding,antacid use before feeding,and diuretic use before feeding between the two groups(all P>0.05).There were significant differences in age,body mass index,Nutritional Risk Screening 2002(NRS 2002),Acute Physi⁃ology and Chronic Health EvaluationⅡ(APACHEⅡ),type of nutrient solution and temperature of enteral nutrient solution between the two groups(all P<0.05).Multivariate analysis showed that age≥55 years old,body mass index≥20.5 kg/m^(2),NRS 2002 score 6-7 points,APACHEⅡscore≥20 points,using short peptide nutrient solution,and tem⁃perature of enteral nutrient solution 36-38℃were independent risk factors for refeeding syndrome in malnourished pa⁃tients(OR=2.208,2.230,2.277,2.277,2.140,2.358,all P<0.05).Conclusion age≥55 years old,body mass index≥20.5 kg/m^(2),NRS 2002 score 6-7 points,APACHEⅡscore≥20 points,using short peptide nutrient solution,and tem⁃perature of enteral nutrient solution 36-38℃are independent risk factors for refeeding syndrome in patients.Therefore,it is necessary to strengthen the monitoring of patients'feeding status,strengthen feeding nursing and nutritional support,and strengthen the control and management of related influencing factors in clinical intervention.

关 键 词：营养不良 再喂养综合征 危险因素 营养支持 

分 类 号：R4[医药卫生—临床医学]