ICU肠内营养病人再喂养综合征影响因素的Meta分析  

Influencing factors of refeeding syndrome with enteral nutrition in ICU patients:a Meta-analysis

作　　者：潘诗婉 洪雅华 李晶晶 梅宛平 PAN Shiwan;HONG Yahua;LI Jingjing;MEI Wanping(School of Nursing,Anhui University of Chinese Medicine,Anhui 230012 China;The First Affiliated Hospital of Anhui University of Chinese Medicine)

机构地区：[1]安徽中医药大学护理学院,安徽230012 [2]安徽中医药大学第一附属医院

出　　处：《循证护理》2025年第4期610-616,共7页Chinese Evidence-Based Nursing

基　　金：2023年度安徽省卫生健康科研项目,编号:AHWJ2023A20431。

摘　　要：目的:通过Meta分析确定重症监护室(ICU)肠内营养病人再喂养综合征的影响因素。方法:计算机检索中国知网、万方数据库、维普数据库、中国生物医学文献数据库、the Cochrane Library、PubMed、Web of Science、EMbase等数据库中有关ICU肠内营养病人再喂养综合征影响因素的相关研究,检索时限从建库至2024年4月。由2名研究者独立对检索文献进行数据提取和质量评价。采用RevMan 5.4软件进行Meta分析。结果:共纳入12篇文献,涉及16个影响因素及3120例病人。Meta分析结果显示,年龄(MD=4.46)、体质指数(OR=2.21)、糖尿病史(OR=1.83)、血清清蛋白水平(OR=4.68)、血清前清蛋白水平(OR=5.40)、鼻肠管喂养(OR=2.79)、喂养速度(OR=4.11)、蛋白质摄入情况(OR=3.91)、热量摄入情况(OR=3.50)、进入ICU 48 h内开始喂养(OR=3.81)、急性生理与慢性健康状况评分(APACHEⅡ)(MD=2.99)、格拉斯哥昏迷评分(GCS)(MD=-1.08)、序贯器官衰竭评分(SOFA)(MD=1.87)、血磷水平(MD=-0.06)、血镁水平(MD=-0.02)为ICU肠内营养病人再喂养综合征的影响因素(P<0.05)。结论:现有证据表明,ICU肠内营养病人发生再喂养综合征的影响因素较多,医护人员应根据以上影响因素进行早期评估与干预,以减少再喂养综合征的发生。Objective:To identify the influencing factors of refeeding syndrome(RFS)in the intensive care unit(ICU)patients with enteral nutrition by Meta-analysis.Methods:Computerized searches were conducted for relevant studies on the factors affecting refeeding syndrome in enteral nutrition patients in ICUs in CNKI,WanFang Database,VIP,CBM,the Cochrane Library,PubMed,Web of Science,EMbase,and other databases.The time frame of the search was from the construction of the database to April 2024.Data extraction and quality assessment of the retrieved literature was performed independently by 2 researchers.Meta-analysis was performed using RevMan 5.4 software.Results:A total of 12 articles were included,involving 16 related influencing factors and 3120 patients.The results of Meta-analysis showed that age(MD=4.46),BMI(OR=2.21),history of diabetes(OR=1.83),albumin level(OR=4.68),prealbumin level(OR=5.40),naso-intestinal feeding(OR=2.79),feeding speed(OR=4.11),protein intake(OR=3.91),calorie intake condition(OR=3.50),initiation of feeding within 48 hours of ICU admission(OR=3.81),APACHEⅡ(MD=2.99),GCS(MD=-1.08),SOFA(MD=1.87),blood phosphorus level(MD=-0.06)and blood magnesium level(MD=-0.02)were the influencing factors for refeeding syndrome in ICU patients with enteral nutrition(P<0.05).Conclusion:Available evidence suggests that there are more influencing factors for the occurrence of refeeding syndrome in enteral nutrition patients in ICU.Healthcare professionals should conduct early assessment and intervention based on these influencing factors to minimize the occurrence of refeeding syndrome.

关 键 词：重症监护室 肠内营养 再喂养综合征 影响因素 META分析 循证护理 

分 类 号：R473[医药卫生—护理学]