[1]黄 润,徐 敏,张海波,等.早期间断肠内营养联合血糖优化管理在心脏外科术后合并应激性高血糖病人中的应用[J].肠外与肠内营养杂志,2025,(01):29-34.[doi:DOI : 10.16151/j.1007-810x.2025.01.005]
　HUANG Run,XU Min,ZHANG Hai-bo,et al.Application of early intermittent enteral nutrition combined withoptimal management of blood glucose in patients with stresshyperglycemia after cardiac surgery[J].PARENTERAL & ENTERAL NUTRITION,2025,(01):29-34.[doi:DOI : 10.16151/j.1007-810x.2025.01.005]
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早期间断肠内营养联合血糖优化管理在心脏外科术后合并应激性高血糖病人中的应用()
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《肠外与肠内营养》杂志[ISSN:1007-810X/CN:32-1477/R]

卷:
期数:
2025年01期
页码:
29-34
栏目:
论著
出版日期:
2025-04-02

文章信息/Info

Title:
Application of early intermittent enteral nutrition combined withoptimal management of blood glucose in patients with stresshyperglycemia after cardiac surgery
作者:
黄 润; 徐 敏; 张海波; 朱益雷
上海交通大学医学院附属新华医院心胸外科，上海 200092
Author(s):
HUANG Run;  XU Min;  ZHANG Hai-bo;  ZHU Yi-lei
Cardiothoracic Surgery , Xinhua Hospital Affiliated to Shanghai Jiao Tong University School ofMedicine, Shanghai 200092,China
关键词:
早期肠内营养 ; 血糖管理 ; 间断喂养 ; 心脏外科术后 ; 应激性高血糖
Keywords:
Early enteral nutrition;  Blood glucose management;  Intermittent feeding;  Postcardiac surgery; Stress-induced hyperglycemia
分类号:
R459.3，R619+.9
DOI:
DOI : 10.16151/j.1007-810x.2025.01.005
文献标志码:
A
摘要:
目的：探讨早期间断肠内营养联合血糖优化管理方案在心脏术后合并应激性高血糖病人中的应用效果。 方法：构建心脏外科术后合并应激性高血糖病人早期间断肠内营养与血糖优化管理方案，前瞻性分析2022年5月至2023年5月上海交通大学医学院附属新华医院心胸外科重症监护室（CICU）心脏外科术后合并应激性高血糖病人200例，采用随机数字表法将其分为对照组（n = 100）和观察组（n = 100），对照组采用常规肠内营养与血糖管理方案，观察组采用早期间断肠内营养联合血糖优化管理方案。比较两组病人营养相关结局指标、血糖管理质量指标及病人预后指标。 结果：实施早期间断肠内营养联合血糖优化管理方案后，观察组病人营养相关指标（血清前清蛋白、血红蛋白、7d热卡达标率）均高于对照组，差异均有统计学意义（P < 0.05）；观察组最大血糖波动幅度、胰岛素使用时间及低血糖发生率明显低于对照组（P < 0.05），葡萄糖目标范围内时间明显高于对照组，差异具有统计学意义（P < 0.05）；观察组机械通气时间、ICU滞留时间及总住院时间均明显低于对照组，差异有统计学意义（P <0.05）。 结论：早期间断肠内营养联合血糖优化管理可有效改善心脏外科术后合并应激性高血糖病人的营养状态，减少血糖波动，提升血糖管理质量，促进病人转归及预后。
Abstract:
Objective: To explore the application effect of early enteral nutrition combined with optimized bloodglucose management in patients with stress hyperglycemia after cardiac surgery. Methods: A study was conducted toconstruct an early enteral nutrition and blood glucose optimization management plan for patients with stresshyperglycemia after cardiac surgery. A prospective analysis was conducted from May 2022 to May 2023 in theCardiothoracic Surgery Intensive Care Unit (CICU) of a tertiary hospital in Shanghai. 200 patients with stresshyperglycemia after cardiac surgery were divided into control group (n = 100) and observation group (n = 100) byrandom number table method. The control group received routine enteral nutrition and blood glucose management plan,while the observation group received early enteral nutrition combined with blood glucose optimization management plan.Nutrition related outcome indicators, blood glucose management quality indicators, and patient prognosis indicators werecompared between two groups of patients. Results: After implementing the early enteral nutrition combined withoptimized blood glucose management plan, the nutritional indicators (serum prealbumin, hemoglobin, and 7-day caloriecompliance rate) of the observation group were higher than those of the control group, and the differences were statistically significant (P < 0.05); The maximum blood glucose fluctuation amplitude, insulin use time, and incidence ofhypoglycemia in the observation group were significantly lower than those in the control group (P < 0.05), and the timewithin the glucose target range was significantly higher than that in the control group, with statistical significance (P <0.05); The mechanical ventilation time, ICU stay time, and total hospital stay in the observation group were significantlylower than those in the control group, and the differences were statistically significant (P < 0.05). Conclusions: Earlyenteral nutrition combined with optimized blood glucose management can effectively improve the nutritional status ofpatients with stress hyperglycemia after cardiac surgery, reduce blood glucose fluctuations, improve blood glucosemanagement quality, and promote patient outcomes and prognosis.

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备注/Memo

备注/Memo:
基金项目 ：上海新华医院第二期十四五护理新苗人才项目（Xhlxm010)；上海交通大学医学院附属新华医院科技基金项目（xhhl?cx2023-04）通讯作者 ：朱益雷，E-mail：zhuyilei@xinhuamed.com.cn
更新日期/Last Update: 1900-01-01