摘要
目的分析不同疾病危重患者肠内营养(EN)的耐受性情况,为减少耐受不良发生率提供依据。方法选择2010年6月—2012年5月入住本院重症监护室(ICU)且采用EN的危重患者163例为研究对象,根据治疗方法分为整蛋白纤维型组72例和短肽型组91例,整蛋白纤维型组给予整蛋白纤维型EN混悬液,短肽型组给予短肽型EN混悬液,均从小剂量开始,根据患者肠道耐受情况调整输注速度和数量,连续滴注。记录并比较两组不同疾病患者耐受良好、部分耐受或不耐受情况及耐受性评分。结果短肽型组消化系统疾病和晚期肿瘤患者EN治疗后耐受良好率较整蛋白纤维型组升高,差异均有统计学意义(P<0.05);两组急性脑血管病、呼吸系统疾病、重症颅脑损伤和其他疾病患者EN治疗后耐受性比较,差异均无统计学意义(P>0.05)。短肽型组消化系统疾病和晚期肿瘤患者EN治疗后耐受性评分较整蛋白纤维型组明显降低,差异均有统计学意义(P<0.05);两组急性脑血管病、呼吸系统疾病、重症颅脑损伤和其他疾病患者EN治疗后耐受性评分比较,差异均无统计学意义(P>0.05)。结论在实施EN支持时,医护人员应对不同疾病危重患者的胃肠功能进行动态评估,制定个性化、合理化的营养方案,从而减少耐受不良发生率。
Objective To explore the tolerance of enteral nutrition （EN） in different types of critically ill patients in order to provide evidence for reducing the incidence of intolerance. Methods 163 critically ill patients with EN admitted to ICU of our hospital from June 2010 to May 2012 were divided into whole protein fiber type group （72 cases） and short peptide type group （91 cases） in accordance with different treatments. The former was given whole protein fiber type enteral nutrition suspension, while the latter was given short peptide type enteral nutrition suspension, with both groups starting from small dose. The drip was continuous and its speed and quantity were adjusted according to intestinal tolerance. Tolerance conditions （ tolerance well, part tolerance and intolerance） and tolerance scores of the two groups were recorded. Results Patients with digestive system disease and advanced cancer showed significantly higher well tolerance rate in short peptide type group than in whole protein fiber type group after EN treatment （P 〈 0. 05）. Patients with acute cerebrovascular disease, respiratory system disease, severe craniocerebral injury and other diseases showed no statistically significant differences in tolerance between the two groups after EN treatment （P 〉 0.05 ）. Patients with digestive system disease and advanced cancer had significantly lower tolerance score in short peptide type group than in whole protein fiber type group after EN treatment （ P 〈 0. 05 ）. Patients with acute cerebrovascular disease, respiratory system disease, severe craniocerebral injury and other diseases showed no statistically significant differences in tolerance scores between the two groups after EN treatment （P 〉 0. 05）. Conclusion In the implementation of enteral nutrition, medical personnel should estimate dynamically gastric bowel function for different critically ill patients, and draw up nutrition plan personally and reasonably, so as to reduce the incidence of intolerance.
出处
《中国全科医学》
CAS
CSCD
北大核心
2013年第2期178-180,共3页
Chinese General Practice
关键词
肠道营养
耐受性
危重病
Enteral nutrition
Tolerance
Critical illness
