[1]张 伟,江海娇,姜小敢,等.危重病人肠内营养喂养不耐受危险因素的Meta分析[J].肠外与肠内营养杂志,2020,(05):313-320.[doi:10.16151/j.1007-810x.2020.04.013]
　ZHANG Wei,JIANG Hai-jiao,JIANG Xiao-gan,et al.Risk factors of enteral feeding intolerance in critical ill patients: a Meta-analysis[J].PARENTERAL & ENTERAL NUTRITION,2020,(05):313-320.[doi:10.16151/j.1007-810x.2020.04.013]
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危重病人肠内营养喂养不耐受危险因素的Meta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:
2020年05期
页码:
313-320
栏目:
论著
出版日期:
2020-09-10

文章信息/Info

Title:
Risk factors of enteral feeding intolerance in critical ill patients: a Meta-analysis
作者:
张 伟; 江海娇; 姜小敢; 李坤坤; 吴允东; 张陆雨
皖南医学院弋矶山医院重症医学科，安徽芜湖 241001
Author(s):
ZHANG Wei;  JIANG Hai-jiao;  JIANG Xiao-gan;  LI Kun-kun;  WU Yun-dong;  ZHANG Lu-yu
Department of Critical Care Medicine, The First Affiliated Hospital of Wannan Medical College,Wuhu, 241001, Anhui, China
关键词:
危重病人 ; 肠内营养 ; 喂养不耐受 ; 危险因素 ; Meta分析
Keywords:
Critical illness;  Enteral Nutrition;  Feeding Intolerance;  Risk factors;  Meta-analysis
分类号:
R47
DOI:
10.16151/j.1007-810x.2020.04.013
文献标志码:
A
摘要:
目的：分析影响危重病人发生肠内营养（EN）喂养不耐受的因素，为保障病人顺利摄入EN提供依据。 方法：计算机检索PubMed、Medline、Web of Science、Cochrane Library、中国知网(CNKI)、中国生物医学文献数据库(CBM)、万方全文数据库、维普中文科技期刊数据库(VIP)关于危重病人发生EN喂养不耐受危险因素的文献，检索时间为各数据库建库至2019年9月，通过RevMan 5.3进行Meta分析。 结果：纳入13篇文献，包括3 591例病人，其中病例组1 353例，对照组2 238例；各因素Meta分析合并比值比(OR)分别为年龄 > 60岁(OR = 1.87)、EN开始时间延迟(OR = 2.33)、腹内压高(OR = 3.94)、使用镇静剂(OR = 1.82)、使用血管活性药(OR = 2.22)、高APACHEⅡ评分(OR = 3.23)、机械通气(OR = 1.77)、低蛋白血症(OR = 2.57)。 结论：年龄 > 60岁、肠内营养开始时间延迟、腹内压高、镇静剂、血管活性药、高 APACHE Ⅱ评分、机械通气及低蛋白血症是危重病人 EN 喂养不耐受的危险因素。
Abstract:
Objective: The current study aimed to explore the risk factors for enteral feeding intolerance in critical ill patients and provide evidence for successful implementation of enteral nutrition. Methods: Literatures concerning the risk factors for enteral feeding intolerance in critical ill patients were searched in these databases, including PubMed, MEDLINE, Web of Science, Cochrane Library, CNKI, CBM, WanFang and VIP from inception to September 2019. Meta analysis was performed by using RevMan 5.3 software. Results: A total of 13 eligible studies were finally included, employing 1 353 patients with enteral feeding intolerance and 2 238 patients as controls. The risk factors for enteral feeding intolerance included the following parameters: age > 60 years (OR = 1.87), delayed initiation of enteral nutrition (OR = 2.33), high intra-abdominal pressure (OR = 3.94), sedatives usage (OR = 1.82), vasoactive drugs usage (OR =2.22), high APACHE II score (OR = 3.23), received mechanical ventilation (OR = 1.77) and hypoproteinemia (OR =2.57). Conclusion: Risk factors of enteral feeding intolerance in critical ill patients are advanced age, delayed enteral nutrition, abdominal hypertension, sedatives usage, vasoactive drug usage, high APACHE II score, received mechanical ventilation and hypoproteinemia.

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备注/Memo

备注/Memo:
基金项目 ：安徽省高校自然科学研究重点项目（KJ2016A718）；安徽省中央引导地方科技发展专项项目(201907d07050001) 作者简介 ：张 伟，护师，医学硕士，从事临床营养研究。E-mail：1799012058@qq.com 通讯作者 ：江海娇，E-mail: 602226835@qq.com
更新日期/Last Update: 1900-01-01