呼吸重症监护病房肠内营养患者腹泻发生现状调查及影响因素分析  

Survey on the occurrence of diarrhoea in enteral nutrition patients in respiratory intensive care unit and analysis of influencing factors

作　　者：余方芳 吴淑华 余小珍 付杰 YU Fangfang;WU Shuhua;YU Xiaozhen;FU Jie(Respiratory Intensive Care Unit,Fuzhou Second General Hospital,Fujian Province,Fuzhou 350007,China;Sterilisa-tion and Supply Centre,Fujian Provincial People's Hospital,Fujian Province,Fuzhou 350004,China)

机构地区：[1]福州市第二总医院呼吸危重症科,福建福州350007 [2]福建省人民医院消毒供应中心,福建福州350004

出　　处：《中国当代医药》2025年第8期126-130,共5页China Modern Medicine

摘　　要：目的探讨呼吸重症监护病房(RICU)肠内营养患者腹泻发生的影响因素。方法回顾性分析2023年3月至10月入住福州市第二总医院RICU行鼻饲肠内营养的95例患者的临床资料,采用单因素分析和二元logistic回归分析行鼻饲肠内营养患者发生腹泻的影响因素。结果95例诊断为肺部感染并行鼻饲肠内营养的患者中,发生腹泻41例(43.16%)。单因素分析结果显示,两组患者的入住RICU时间、合并糖尿病史、合并低蛋白血症、营养风险筛查2002(NRS 2002)评分、应用抗生素时间、是否行机械通气、是否鼻饲钾制剂,以及是否鼻饲益生菌比较,差异有统计学意义(P<0.05)。二元logistic回归法分析结果显示:机械通气(β=1.993,OR=7.336,95%CI:1.313~40.997,P=0.023)、鼻饲钾制剂(β=1.399,OR=4.051,95%CI:1.164~14.104,P=0.013)是RICU肠内营养腹泻发生的独立危险因素,鼻饲益生菌(β=-1.503,OR=0.222,95%CI:0.068~0.731,P=0.028)是腹泻的独立保护因素。结论机械通气、鼻饲钾制剂,以及鼻饲益生菌是RICU患者发生腹泻的独立影响因素。该结论为制订降低和预防RICU肠内营养患者腹泻发生的集束化护理干预提供参考依据。Objective To explore the influencing factors of the occurrence of diarrhoea in patients with enteral nutrition in respiratory intensive care unit(RICU).Methods The clinical data of 95 patients who were admitted to the RICU of the Second General Hospital of Fuzhou for enteral nutrition from March to October 2023 were retrospectively analyzed.Univariate analysis and binary logistic regression were used to analyze the influencing factors of diarrhea in patients with enteral nutrition.Results Among 95 patients who were diagnosed with pulmonary infection and received enteral nutrition,41(43.16%)had diarrhea.The results of univariate analysis showed that there were statistically significant differences between the two groups in the length of RICU stay,history of diabetes,hypoproteinemia,nutritional risk screening 2002(NRS 2002)score,time of antibiotic application,mechanical ventilation,nasal potassium preparation,and nasal probiotics(P<0.05).The results of binary logistic regression analysis showed that mechanical ventilation(β=1.993,OR=7.336,95%CI:1.313-40.997,P=0.023),nasal feeding potassium preparation(β=1.399,OR=4.051,95%CI:1.164-14.104,P=0.013)were the independent risk factors for diarrhea in RICU enteral nutrition,and nasal feeding probiotics(β=-1.503,OR=0.222,95%CI:0.068-0.731,P=0.028)was the independent protective factor for diarrhea.Conclusion Mechanical ventilation,nasal potassium preparation and probiotics are the independent influencing factors of diarrhea in RICU patients.This conclusion provides a reference for the development of cluster nursing intervention to reduce and prevent the occurrence of diarrhea in patients with enteral nutrition in RICU.

关 键 词：呼吸重症监护室 肺炎 肠道营养 腹泻 

分 类 号：R563[医药卫生—呼吸系统] R574[医药卫生—内科学]