[1]姚红林,薛阳阳,江方正,等.腹腔压力分级管理在慢重症病人肠内营养 实施中的效果与评价[J].肠外与肠内营养杂志,2020,(02):100-103.[doi:10.16151/j.1007-810x.2020.02.008]
 YAO Hong-lin,XUE Yang-yang,JIANG Fang-zheng,et al.Effects of intra-abdominal pressure-directed management on enteral nutrition therapy for patients with chronic critical illness[J].PARENTERAL & ENTERAL NUTRITION,2020,(02):100-103.[doi:10.16151/j.1007-810x.2020.02.008]
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腹腔压力分级管理在慢重症病人肠内营养 实施中的效果与评价
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《肠外与肠内营养》杂志[ISSN:1007-810X/CN:32-1477/R]

卷:
期数:
2020年02期
页码:
100-103
栏目:
论著
出版日期:
2020-03-10

文章信息/Info

Title:
Effects of intra-abdominal pressure-directed management on enteral nutrition therapy for patients with chronic critical illness
作者:
姚红林薛阳阳江方正童智慧李维勤
东部战区总医院 普通外科研究所,江苏南京 210000
Author(s):
YAO Hong-lin XUE Yang-yang JIANG Fang-zheng TONG Zhi-hui LI Wei-qin
Research Institute of General Surgery, Jinling Hospital, Nanjing 210000, Jiangsu, China
关键词:
腹腔高压 腹内压 慢重症 重症病人 肠内营养耐受性
Keywords:
Intra-abdominal hypertension Intra-abdominal pressure Chronic critical illness Critically ill patients Enteral nutrition tolerance
分类号:
R459.3 R472
DOI:
10.16151/j.1007-810x.2020.02.008
文献标志码:
A
摘要:
目的:分析腹腔压力分级管理在慢重症病人肠内营养(EN)实施中的效果。 方法:回顾分析2018年 8月至2019年7月入住东部战区总医院普通外科7ICU的慢重症实施EN的病人。主要指标是ICU的住院时间。 结果:研究共纳入100例符合纳排标准的慢重症病人,其中50(50%)例在EN期间实施腹腔压力分级管理(腹腔压力 导向组/观察组),50(50%)例实施常规EN治疗(标准组/对照组)。腹腔压力导向组病人ICU住院时间较对照组病 人明显缩短[(24.98 ± 5.24) d vs (27.48 ± 6.18) d,P = 0.031]。观察组病人在EN出现不耐受的总例次情况明显好于对 照组(14次vs 42次,P < 0.05)。观察组病人的喂养中断情况和中断时间明显低于对照组病人(P < 0.05)。观察组病 人营养指标(血清总蛋白、血红蛋白、体质量指数)在实施腹腔压力分级管理14 d后明显好于对照组(P < 0.05),此 外,观察组较对照组相比目标喂养量更易达标[(92.98 ± 9.67)% vs (83.06 ± 20.03)% ,P < 0.01]。 结论:慢重症病人 EN期间通过腹腔压力分级管理可以改善预后,可用于慢重症病人的治疗。
Abstract:
Objective: To evaluate the effect of intra-abdominal pressure-directed (IAP-directed) management on enteral nutrition (EN) for patients with chronic critical illness (CCI). Methods: This retrospective study reviewed electronic medical records for all patients with CCI who received EN and were admitted to the department of surgical intensive care unit (SICU), general hospital of eastern theater command from August 2018 to July 2019. The primary outcome was the length of ICU stay. Results: A total of 100 patients were enrolled in the study. Among these cases, 50 patients received IAP-directed EN therapy (IAP-directed group) and the remaining 50 patients received the standard EN therapy (standard group). The length of ICU stay in IAP-directed group was significantly shorter than that in standard group [(24.98 ± 5.24) d vs (27.48 ± 6.18) d, P = 0.031]. The incidence of EN intolerance in IAP-directed group was significantly lower than that in standard group (14 vs 42, P < 0.05), and so did the incidence and the time of feeding interruption (P < 0.05). After 14 days of the treatment, the nutritional parameters of serum total proteins, hemoglobin and body mass index in IAP-directed group were significantly higher than those in standard group (P < 0.05). Moreover, the target-reaching rate of EN in IAP-directed group was significantly higher than that in standard group [(92.98 ± 9.67)% vs (83.06 ± 20.03)%, P < 0.01]. Conclusion: IAP-directed EN therapy can improve the clinical outcomes and could be used as a therapeutic modality for the patients with CCI.

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备注/Memo

备注/Memo:
基金项目 :军事医学创新工程项目(18CXZ040) 作者简介 :姚红林,主管护师,护理本科,从事普通外科重症的护理工作及研究。E-mail:1357236687@qq.com 通讯作者 :薛阳阳,E-mail:alexyangzi@126.com
更新日期/Last Update: 1900-01-01