基于证据的肠瘘患者肠内营养耐受性护理方案的制订及应用研究  

Study on the formulation and application of evidence-based nursing scheme for enteral nutrition tolerance in patients with intestinal fistula

作　　者：黄艳[1] 杨娟[1] 秦月兰[2] 李珍 袁平[3] HUANG Yan;YANG Juan;QIN Yuelan;LI Zhen;YUAN Ping(Department of General Surgery,Hunan Provincial People’s Hospital(the First Affiliated Hospital of Hunan Normal University),Hunan,Changsha 410005,China;Nursing Department,Hunan Provincial People’s Hospital(the First Affiliated Hospital of Hunan Normal University),Hunan,Changsha 410005,China;Wound and Stoma Center,Hunan Provincial People’s Hospital(the First Affiliated Hospital of Hunan Normal University),Hunan,Changsha 410005,China)

机构地区：[1]湖南省人民医院(湖南师范大学附属第一医院)普外科,湖南长沙410005 [2]湖南省人民医院(湖南师范大学附属第一医院)护理部,湖南长沙410005 [3]湖南省人民医院(湖南师范大学附属第一医院)伤口造口中心,湖南长沙410005

出　　处：《中国医药科学》2025年第1期132-136,共5页China Medicine And Pharmacy

基　　金：湖南省卫生健康委科研计划项目(202214023448;202114042053)。

摘　　要：目的制订基于证据的肠瘘患者肠内营养耐受性护理方案,并探讨其应用效果。方法选取2021年1—11月在湖南省人民医院普外科行肠内营养治疗的57例肠瘘患者为研究对象,其中1—5月的29例为对照组,采用常规护理方案;6—11月的28例为试验组,采用基于证据的肠瘘患者肠内营养耐受性护理方案。比较两组干预期间不耐受症状、喂养中断的发生情况,护理前及实施肠内营养两周后营养指标,目标喂养量达标情况。结果观察期间试验组不耐受症状和喂养中断发生率低于对照组,目标喂养量达标率高于对照组,差异有统计学意义(P<0.05);两周后,试验组白蛋白、前白蛋白高于对照组,差异有统计学意义(P<0.05);两组体重指数、总蛋白、血红蛋白比较,差异无统计学意义(P>0.05)。结论基于证据的护理方案可减少肠瘘患者肠内营养治疗过程中不耐受症状及喂养中断的发生,提高目标喂养量达标率,改善患者营养状态。Objective To formulate an evidence-based nursing plan of enteral nutrition tolerance for patients with intestinal fistula,and to explore its application effect.Methods A total of 57 patients with intestinal fistula who received enteral nutrition treatment in the Department of General Surgery,Hunan Provincial People’s Hospital from January to November,2021 were selected as the study subjects.Among them,29 patients from January to May were selected as the control group and received routine nursing care,28 cases from June to November were selected as the experimental group,and an evidence-based enteral nutrition tolerance nursing plan was adopted for patients with intestinal fistula.The symptoms of intolerance,the occurrence of feeding interruption,the nutritional indexes before nursing and after two weeks of enteral nutrition,and the target feeding amount were compared between the two groups.Results During the observation period,the incidence of intolerance symptoms and feeding interruption in the experimental group were lower than that in the control group,and the target feeding rate was higher than that in the control group,with statistically significant differences(P<0.05).After two weeks,the albumin and prealbumin in the experimental group were higher than those in the control group,and the differences were statistically significant(P<0.05).There was no significant difference in body mass index,total protein and hemoglobin between the two groups(P>0.05).Conclusion Evidence-based nursing scheme can reduce the occurrence of intolerance symptoms and feeding interruption in the process of enteral nutrition treatment for patients with intestinal fistula,improve the target feeding rate and improve the nutritional status of patients.

关 键 词：肠瘘 肠内营养 耐受性 护理 

分 类 号：R473.6[医药卫生—护理学]