[1]叶向红,宫雪梅,薛阳阳.早期肠内营养护理方案对重症病人热卡达标率及喂养不耐受的 前后对照研究[J].肠外与肠内营养杂志,2021,(04):230-235.[doi:10.16151/j.1007-810x.2021.04.009]
　YE Xiang-hong,GONG Xue-mei,XUE Yang-yang.The effects of a nurse-driven feeding protocol on target reaching rate and feeding tolerance in critically ill patients: A before and after study[J].PARENTERAL & ENTERAL NUTRITION,2021,(04):230-235.[doi:10.16151/j.1007-810x.2021.04.009]
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早期肠内营养护理方案对重症病人热卡达标率及喂养不耐受的 前后对照研究
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《肠外与肠内营养》杂志[ISSN:1007-810X/CN:32-1477/R]

卷:
期数:
2021年04期
页码:
230-235
栏目:
论著
出版日期:
2021-07-10

文章信息/Info

Title:
The effects of a nurse-driven feeding protocol on target reaching rate and feeding tolerance in critically ill patients: A before and after study
作者:
叶向红1; 宫雪梅2; 薛阳阳 1
1.东部战区总医院普通外科研究所，江苏南京 210002；2.深圳市人民医院心脏大血管外科，广东 深圳 518000
Author(s):
YE Xiang-hong1;  GONG Xue-mei2;  XUE Yang-yang3
1. Research Institute of General Surgery, General Hospital of Eastern Theater Command, Nanjing 210002, Jiangsu, China;2.Department of Cardiac macrovascular Surgery, Shenzhen People's Hospital,Shenzhen, 518020, Guangdong, China
关键词:
危重症 ; 肠内营养 ; 护理 ; 热卡达标率; 喂养不耐受
Keywords:
Critically ill;  Enteral nutrition;  Nursing;  Calorie target reaching rate;  Feeding intolerance
分类号:
R459.3
DOI:
10.16151/j.1007-810x.2021.04.009
文献标志码:
A
摘要:
目的：探讨早期肠内营养（EEN）护理方案对重症病人热卡达标率及喂养不耐受的影响。 方法：选取 2018年 6月至 2019年 1月入住东部战区总医院重症监护病房，实施肠内营养（EN）的重症病人 214例。按照入院时间分为干预组和对照组，每组各 107例。对照组采用常规营养支持治疗；干预组采用 EEN护理方案，比较两组 7 d热卡达标率、每日热卡摄入量、喂养不耐受症状、预后指标、营养指标。 结果：干预组 7 d热卡达标率明显高于对照组，差异具有统计学意义（P < 0.05）；干预组喂养不耐受症状与喂养中断次数少于对照组（P < 0.05）；两组 7 d营养学指标和炎症指标差异有统计学意义（P < 0.05）；两组机械通气时间、ICU住院时间、28 d病死率无显著统计学差异（P > 0.05）。 结论：实施 EEN护理方案能够提高重症病人热卡达标率，改善喂养不耐受症状，减少喂养中断次数，有效改善重症病人的临床结局。
Abstract:
Objective: To investigate the effects of implementing a nurse-driven enteral feeding protocol on calorie target reaching rate and feeding tolerance in critically ill patients. Methods: Nutrition and clinical outcomerelated parameters from patients who were admitted to our treatment center from June 2018 to August 2018 (the history control group, n = 107) and November 2018 to January 2019 (the study group, n = 107) were collected. Patients were assigned into the control group (receiving routine medical care) and the study group (receiving nurse-driven early enteral nutrition protocol). Calorie target reaching rate by day 7, daily calorie intake, feeding intolerance associated symptoms, clinical outcomes and nutrition indicators were collected. Results: Implementation of the nurse-driven feeding protocol resulted in a higher calorie target reaching rate by day 7 (P < 0.05). In the study group, the incidences of feeding intolerance and feeding interruptions were lower compared with the control group (P < 0.05). Adoption of the feeding protocol resulted in significant improvements in nutrition indicators and inflammatory indicators by day 7 (P < 0.05). In addition, the need of mechanical ventilation, length of ICU stay and 28-day mortality did not differ between the two groups. Conclusion: The implementation of a nurse-driven feeding protocol could increase calorie target reaching rate, reduce feeding interruptions and incidence of feeding intolerance, improve the nutritional intake and clinical outcomes in critically ill patients.

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备注/Memo

备注/Memo:
基金项目 ：军事医学创新工程（18CXZ040） 作者简介 ：叶向红，主任护师，医学本科，从事外科及重症护理工作。E-mail：icuyz@126.com
更新日期/Last Update: 1900-01-01