[1]胡佳佳,顾璐璐,吴翠丽,等.临时性回肠造口重症病人早期肠内营养相关性腹泻的影响因素分析[J].肠外与肠内营养杂志,2025,(01):48-53.[doi:10.16151/j.1007-810x.2025.01.008]
　HU Jia-jia,GU Lu-lu,WU Cui-li,et al.Analysis of the influencing factors of early enteral nutrition-related diarrhea in severe patients with temporary ileostomy[J].PARENTERAL & ENTERAL NUTRITION,2025,(01):48-53.[doi:10.16151/j.1007-810x.2025.01.008]
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临时性回肠造口重症病人早期肠内营养相关性腹泻的影响因素分析()
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《肠外与肠内营养》杂志[ISSN:1007-810X/CN:32-1477/R]

卷:
期数:
2025年01期
页码:
48-53
栏目:
论著
出版日期:
2025-04-02

文章信息/Info

Title:
Analysis of the influencing factors of early enteral nutrition-related diarrhea in severe patients with temporary ileostomy
作者:
胡佳佳1; 顾璐璐1; 吴翠丽1; 叶向红1; 蒋 妍2; 王新颖1
1.中国人民解放军东部战区总医院普通外科，江苏南京 210002；2.南京医科大学医政学院，江苏南京 211166
Author(s):
HU Jia-jia1;  GU Lu-lu1;  WU Cui-li1;  YE Xiang-hong1;  JIANG Yan2;  WANG Xin-ying1
1.Research Institute of General Surgery, Jingling Hospital, Nanjing 210002, Jiangsu, China;2.Schoolof Medical Administration, Nanjing Medical University, Nanjing 211166, Jiangsu, China
关键词:
ICU ; 临时性回肠造口 ; 早期肠内营养 ; 腹泻 ; 影响因素
Keywords:
ICU;  Temporary ileostomy;  Early enteral nutrition;  Diarrhea;  Influencing factor
分类号:
R473.6
DOI:
10.16151/j.1007-810x.2025.01.008
文献标志码:
A
摘要:
目的：分析临时性回肠造口重症病人早期肠内营养治疗期间腹泻的影响因素。 方法：回顾性收集2019年11月至2023年11月东部战区总医院普通外科临时性回肠造口术后接受早期肠内营养治疗的重症病人154例。根据病人是否发生肠内营养相关性腹泻分为腹泻组和非腹泻组，比较两组病人临床资料，进行单因素分析，将有显著差异的指标纳入多因素Logistic回归模型，分析临时性回肠造口重症病人术后早期肠内营养治疗期间腹泻的影响因素。 结果：154 例病人中共 43 例在行早期肠内营养治疗期间发生了肠内营养相关性腹泻，发生率为27.9%，经多因素Logistic回归分析显示，肠内营养输注速度（OR = 6.342, P ＝ 0.001,95%CI: 2.055 ~19.572）、抗生素的使用种类（OR = 8.342, P ＝ 0.013,95%CI: 1.577 ~ 44.119）、机械通气（OR = 7.011, P ＝ 0.001, 95%CI: 2.272 ~21.629)、肠内营养制剂类型（OR = 6.497, P ＝ 0.001,95%CI: 2.177 ~ 19.392）及糖尿病（OR = 3.321, P = 0.036,95%CI: 1.080 ~ 10.215）与临时性回肠造口重症病人术后早期肠内营养相关性腹泻有关。 结论：临时性回肠造口重症病人术后早期肠内营养治疗期间腹泻的发生率较高，营养治疗期间应关注肠内营养输注速度、抗生素使用、机械通气、肠内营养制剂类型及糖尿病。
Abstract:
Objective: To investigate the influencing factors of diarrhea during early enteral nutrition (EEN) therapy in severe patients with temporary ileostomy. Method: A total of 154 patients with temporary ileostomy who received EEN in the Department of General Surgery, Jinling Hospital from November 2019 to November 2023 were included in this study. All patients were divided into two groups: the diarrhea group (n = 43) and the non-diarrhea group (n = 111). The clinical data of the patients were retrospectively collected and analyzed, and univariate analysis was performed to compare the differences between groups. The indicators with significant differences were subjected to multivariate logistic regression analysis to determine the influencing factors of diarrhea during EEN therapy in severe patients with temporary ileostomy. Result: Among the 154 patients, 43 developed diarrhea during EEN therapy, with an incidence of 27.9%. Multivariate logistic regression analysis showed that enteral nutrition (EN) infusion rate (OR =6.342, P ＝ 0.001, 95%CI: 2.055 ~ 19.572), antibiotics type (OR = 8.342, P ＝ 0.013, 95%CI: 1.577 ~ 44.119), mechanical ventilation (OR = 7.011, P ＝ 0.001, 95%CI: 2.272 ~ 21.629), EN formulation type (OR = 6.497, P ＝ 0.001, 95%CI: 2.177 ~ 19.392), and diabetes (OR = 3.321, P = 0.036,95%CI: 1.080 ~ 10.215) were closely associated with ENrelated diarrhea in severe patients with temporary ileostomy. Conclusion: There was a high incidence of diarrhea in severe patients with temporary ileostomy who received EEN. EN infusion rate, antibiotics use, mechanical ventilation, EN formulation type and diabetes were the influencing factors for presence of EEN-related diarrhea in the patients. Our data could provide a reference for preventing EEN-related diarrhea in severe patients with temporary ileostomy after surgery.

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备注/Memo

备注/Memo:
基金项目 ：东部战区总医院院内课题（YYHL2021059,22HLZX17）通讯作者 ：吴翠丽，E-mail：229365868@qq.com
更新日期/Last Update: 1900-01-01