肠内营养支持脓毒血症患儿再喂养综合征发生现状及其影响因素  

Current Situation and Influencing Factors of Refeeding Syndrome in Children with Sepsis Supported Receiving Enteral Nutrition Support

作　　者：邵彤 赵月月 马洁[1] 许丹丹[1] 郭洁[1] SHAO Tong;ZHAO Yueyue;MA Jie;XU Dandan;GUO Jie(Internal Care Unit,Children’s Hospital of Zhengzhou University,Henan Children’s Hospital,Zhengzhou Children’s Hospital,Zhengzhou 450012,China)

机构地区：[1]郑州大学附属儿童医院,河南省儿童医院郑州儿童医院内科监护室,河南郑州450012

出　　处：《河南医学研究》2025年第4期607-610,共4页Henan Medical Research

基　　金：2023年河南省医学科技攻关计划项目(LHGJ20230557)。

摘　　要：目的探讨肠内营养支持脓毒血症患儿再喂养综合征(RFS)发生现状及其影响因素。方法将2023年1月至2024年4月在郑州大学附属儿童医院就诊的120例脓毒血症患儿纳入研究,根据患儿在肠内营养支持期间是否出现RFS将其分为对照组和观察组,对照组患儿未合并RFS,共91例;观察组患儿合并RFS,共29例。收集患者一般资料,使用单因素分析、二元logistic回归分析法分析影响脓毒血症患儿RFS发生的独立危险因素。结果单因素分析、二元logistic回归分析结果显示肠内营养启动时间>48 h、平均热量摄入量高、营养风险筛查2002(NRS 2002)评分≥3分、急性生理学和慢性健康评估Ⅱ(APACHE-Ⅱ)评分≥15分以及白蛋白、前白蛋白水平低是导致肠内营养支持脓毒血症患儿RFS发生的独立危险因素。结论接受肠内营养支持治疗的脓毒血症患儿RFS发生与营养支持方案、患儿自身生理状态等多种因素影响,临床研究人员应加强对高危因素的监测,并给予针对性预防措施,以降低RFS发生风险。Objective To investigate the current status and influencing factors of refeeding syndrome(RFS)in children with sepsis receiving enteral nutrition support.Methods A total of 120 children with sepsis who were admitted to Children’s Hospital of Zhengzhou University from January 2023 to April 2024 were enrolled in the study.According to whether the children had RFS during enteral nutrition support,they were divided into control group and observation group.The children in the control group did not have RFS(91 cases),and there were 29 children with RFS in the observation group.The general data of the patients were collected.Univariate analysis and binary logistic regression analysis were used to analyze the independent risk factors affecting the occurrence of RFS in children with sepsis.Results Univariate analysis and binary logistic regression analysis showed that enteral nutrition initiation time>48 hours,high average caloric intake,nutrition risk screening 2002(NRS 2002)score≥3,acutephysiology and chronic health evaluation-Ⅱ(APACHE-Ⅱ)score≥15,and low albumin and prealbumin levels were independent risk factors for RFS in children with sepsis receiving enteral nutrition support.Conclusion The occurrence of RFS in children with sepsis who receive enteral nutrition support is affected by many factors,such as the nutritional support program and the physiological state of the children.Clinical researchers should strengthen the detection of high risk factors and provide targeted preventive measures to reduce the risk of RFS.

关 键 词：脓毒血症 肠内营养支持 再喂养综合征 影响因素 

分 类 号：R631[医药卫生—外科学]