ICU患者早期肠内营养中大便次数变化在耐受性评估中作用的研究  

Study on the effect of changes in stool frequency in early enteral nutrition of ICU patients on tolerance assessment

作　　者：丘宇茹[1] 蔡敏[1] 李子樱 王吉文[1] QIU Yu-ru;CAI Min;LI Zi-ying;WANG Ji-wen(Yat-sen Memorial Hospital of Sun Yat-sen University,Guangzhou,510120,China)

机构地区：[1]中山大学孙逸仙纪念医院,广州市510120

出　　处：《岭南现代临床外科》2024年第5期320-325,共6页Lingnan Modern Clinics in Surgery

基　　金：广东省医学科学技术研究基金项目(A2021309)。

摘　　要：目的研究在ICU患者早期肠内营养(EN)耐受性评估方法的效能及大便次数监测变化的作用。方法通过回顾性收集2021年1月1日至2023年5月30日符合入选标准的患者的基础资料和EN前后的第1~7天的GRV、大便次数、腹围、膀胱压进行分组,分析比较各观察指标的变化趋势、异常的发生时间和发生率、作为最早判定耐受依据的百分率。结果ICU患者早期EN不耐受的发生率为85.9%,最多见为大便异常,91.1%出现过日无大便,连续3天以上无大便为40.3%,腹泻占47.6%;不耐受组大便异常发生率90.2%,平均发生时间4.0天,第4天超过3天无大便和腹泻发生率均最高;作为最早判定不耐受依据中百分率由高往低依次为腹泻、膀胱压增加、超过3天无大便、GRV、腹围增加、腹胀。结论ICU患者早期EN不耐受的发生率为85.9%,作为早期识别EN不耐受的方法,无大便与腹泻均表现较好的评估价值,在ICU的EN中应予以重视。Objective To investigate the efficacy of assessment of early enteral nutrition(EN)toler-ance in ICU patients and the role of abnormal stool frequency monitoring.Methods The basic data of patients who met the inclusion criteria from January 1,2021 to May 30,2023,and the GRV,stool frequency,abdominal circumference,and bladder pressure on the 1st to 7th day before and after EN were retrospectively collected and grouped into groups.The change trend of each observation index,the occurrence time and incidence of abnormalities,and the percentage as the earliest basis for determining tolerance were analyzed and compared.Results The incidence of EN intolerance in ICU patients was 85.9%,the most common was abnormal stool,91.1%had no stool for a day,40.3%had no stool for more than 3 days,and 47.6%had diarrhea.In the intolerance group,the incidence of abnormal stool was 90.2%,the average occurrence time was 4.0 days,and the incidence of diarrhea was the highest on the 4th day with more than 3 days absence.As the basis for the earliest determination of intolerance,the percent-age from high to low was diarrhea,increased bladder pressure,no stool for more than 3 days,GRV,increased abdominal circumference,and abdominal distension.Conclusion The incidence of early EN intolerance in ICU patients was 85.9%.As a method for early identification of EN intolerance,both no stool and diarrhea showed good evaluation value,and should be paid attention to in ICU EN management.

关 键 词：ICU患者 肠内营养 耐受性 大便异常 

分 类 号：R459.3[医药卫生—治疗学]