[1]李嘉琪,等.高营养风险机械通气病人肠内营养喂养达标与呼吸机拔管的相关性分析[J].肠外与肠内营养杂志,2023,(04):239-243.[doi:DOI : 10.16151/j.1007-810x.2023.04.008]
　LI Jia-qi,ZUO Jun-tao,XU Yao,et al.The correlation between standard enteral nutrition feeding and extubation inmechanically ventilated patients with high nutritional risk[J].PARENTERAL & ENTERAL NUTRITION,2023,(04):239-243.[doi:DOI : 10.16151/j.1007-810x.2023.04.008]
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高营养风险机械通气病人肠内营养喂养达标与呼吸机拔管的相关性分析()
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《肠外与肠内营养》杂志[ISSN:1007-810X/CN:32-1477/R]

卷:
期数:
2023年04期
页码:
239-243
栏目:
论著
出版日期:
2023-08-10

文章信息/Info

Title:
The correlation between standard enteral nutrition feeding and extubation inmechanically ventilated patients with high nutritional risk
作者:
李嘉琪 1;  3; 左俊焘 1;  3; 徐 瑶 2; 吴翠丽 3; 叶向红 3
1. 南京大学医学院，江苏南京 210093；2. 蚌埠医学院研究生院，安徽蚌埠 233000；3. 南京大学附属金陵医院/东部战区总医院普通外科，江苏南京 210002
Author(s):
LI Jia-qi1; 3;  ZUO Jun-tao1; 3;  XU Yao2;  WU Cui-li3;  YE Xiang-hong3
1.Medical College, Nanjing University, Nanjing 210093, Jiangsu, China；2.Graduate School, BengbuMedical College, Bengbu 233000, Anhui, China；3. Affilated Jingling Hospital, Medical School ofNanjing University 210002, Jiangsu, China
关键词:
肠内营养 ; 呼吸机拔管 ; 高营养风险 ; 机械通气
Keywords:
Enteral nutrition;  Extubation;  High nutritional risk;  Mechanical ventilation
分类号:
R459.3，R563.1
DOI:
DOI : 10.16151/j.1007-810x.2023.04.008
文献标志码:
A
摘要:
目的：探讨高营养风险机械通气病人肠内营养是否达标与呼吸机拔管的相关性及呼吸机拔管失败的影响因素。 方法：回顾性分析普通外科 ICU 接收的 105 例重症病人，将病人分为拔管成功组(n = 55)和拔管失败组(n = 50)，比较两组病人喂养达标率、喂养不耐受状况、住院时间及 28d 死亡率，并分析喂养达标与呼吸机拔管的相关性。 结果：两组男性占比居多，拔管成功组为 41(74.65%)，拔管失败组为 39(78.0%)，拔管成功组不耐受发生率为 19(34.5%)，拔管失败组不耐受发生率为 18(36.0%)。拔管成功组的喂养达标率为 33(60.0%)，拔管失败组为 7(14.0%)，P = 0.002；拔管成功组住院时间为 26.5(13.5,63)，拔管失败组为 40(27.5,65)，P < 0.05；拔管成功组 28 d 死亡率为 3.6%，拔管失败组为 20%，P < 0.05。Spearman 等级相关分析显示喂养达标与呼吸机拔管成功与否呈负相关(r = -0.421, P < 0.01),当喂养达标率越高时，呼吸机拔管的失败率越低。多因素 Logistic 回归分析表明，EN 不达标是呼吸机拔管失败的独立危险因素。 结论：高营养风险机械通气病人呼吸机拔管失败与 EN 不达标有关，导致病人住院时间延长，28 d 死亡率增加。
Abstract:
Objective: To explore the correlation between standard enteral nutrition and extubation in mechanicalventilation patients with high nutritional risk and the influencing factors of extubation failure. Methods: 105 patientsadmitted to general surgery ICU were divided into successful extubation group (n = 55) and failed extubation group (n=50). The feeding standards, feeding intolerances, length of stay and 28 d mortality of the two groups were compared, andthe correlation between feeding standards and extubation was analyzed. Results: The proportion of males in the twogroups was 41(74.65%) in the successful extubation group and 39 (78.0%) in the failed extubation group. The incidenceof intolerance in the successful extubation group was 19(34.5%) and in the failed extubation group was 18(36.0%). Thefeeding attainment rate was 33(60.0%) in the successful extubation group and 7(14.0%) in the failed extubation group.The length of hospital stay was 26.5(13.5,63) in the successful extubation group, 40(27.5,65) in the failed extubationgroup (P < 0.05), and the 28d mortality was 3.6% in the successful extubation group. The extubation failure group was20%(P < 0.05). Spearman analysis showed that the feeding standard was negatively correlated with the success ofextubation (r = -0.421, P < 0.01). The higher the feeding standard rate was, the lower the failure rate of extubation was.Multivariate Logistic regression analysis showed that EN substandard was an independent risk factor for extubation failure. Conclusion: The failure of the extubation in mechanical ventilation patients with high nutritional risk is relatedto EN sub-standard, which leads to prolonged hospital stay and increased mortality at 28 days.

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备注/Memo

备注/Memo:
作者简介 ：李嘉琪，护理硕士研究生，从事重症营养研究。E-mail：2021342759@qq.com通讯作者 ：叶向红，E-mail：icuyz@126.com
更新日期/Last Update: 1900-01-01