[1]姚红林,江方正,叶向红,等.个体化运动处方在妊娠晚期重症急性胰腺炎营养支持治疗中的效果评价[J].肠外与肠内营养杂志,2022,(02):104-109.[doi:DOI : 10.16151/j.1007-810x.2022.02.009]
　YAO Hong-ling,JIANG Fang-zheng,YE Xiang-hong,et al.The application and evaluation of individualized exercise prescription in the nutritional management of patients in the late pregnancy combined with severe acute pancreatitis[J].PARENTERAL & ENTERAL NUTRITION,2022,(02):104-109.[doi:DOI : 10.16151/j.1007-810x.2022.02.009]
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个体化运动处方在妊娠晚期重症急性胰腺炎营养支持治疗中的效果评价
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《肠外与肠内营养》杂志[ISSN:1007-810X/CN:32-1477/R]

卷:
期数:
2022年02期
页码:
104-109
栏目:
论著
出版日期:
2022-03-10

文章信息/Info

Title:
The application and evaluation of individualized exercise prescription in the nutritional management of patients in the late pregnancy combined with severe acute pancreatitis
作者:
姚红林1; 江方正2; 叶向红 1; 赵雪成 1; 薛阳阳1; 高 堃3; 童智慧3; 李维勤3
东部战区总医院/南京大学医学院附属金陵医院，1.全军普通外科研究所；2.秦淮医疗区重症医学科；3.重症医学科，江苏南京 210002
Author(s):
YAO Hong-ling1;  JIANG Fang-zheng2;  YE Xiang-hong1;  ZHAO Xue-cheng1;  XUE Yang-yang1; GAO Kun3;  TONG Zhi-hui3;  LI Wei-qin3
1.Department of general surgery；2.Department of critical care medicine, Qinhuai medical district；3. Department of critical care medicine, Jinling Hospital, Medical school of Nanjing university, Nanjing 210002, Jiangsu, China
关键词:
运动处方 ; 功能锻炼 ; 个体化治疗 ; 营养支持治疗 ; 妊娠晚期 ; 重症急性胰腺炎
Keywords:
Exercise prescription;  Functional exercise;  Individualized treatment;  Nutritional support;  Late pregnancy;  Severe acute pancreatitis
分类号:
R657.5
DOI:
DOI : 10.16151/j.1007-810x.2022.02.009
文献标志码:
A
摘要:
目的：观察个体化运动处方在妊娠晚期重症急性胰腺炎营养支持治疗中的效果。 方法：选择 2016年 1月至 2020年 7月东部战区总医院重症急性胰腺炎治疗中心的妊娠期重症急性胰腺炎(SAPIP)住院病人共 46例，2016年 1月至 2017年 12月收治的 23例为对照组，2018年 1月至 2020年 7月收治的 23例为干预组。对照组常规胸部物理治疗和四肢功能锻炼；干预组采取个体化运动处方功能锻炼方案。两组病人在实施肠内营养（EN）期间，采用 EN耐受性评估与管理工具，每 6小时对病人进行评价与护理对策调整，以帮助 EN能够顺利实施。观察两组病人实施个体化运动处方后 0 d、3 d、7 d、14 d时 ICU获得性肌无力医学研究理事会评分 MRC分值变化；观察两组病人EN期间耐受性情况和 EN喂养中断次数；观察两组病人 0 d、3 d、7 d、14 d血清总蛋白、血红蛋白和体质量指数的变化；观察两组病人 0 d、3 d、7 d、14 d机体肌肉总量、骨骼肌、体脂肪、躯干水分、四肢水分的变化。 结果：干预组病人在干预后 7 d、10 d、14 d时 MRC分值显著高于对照组（P < 0.05）。干预组病人在 7 d、14 d的血清总蛋白、血红蛋白、体质量指数高于对照组(P < 0.05)；干预组 EN期间发生不耐受的情况少于对照组，腹胀发生率显著低于对照组（P < 0.05）；EN中断次数少于对照组（P < 0.05）。 结论：个体化运动处方指导病人功能锻炼可促进营养物质充分吸收和利用，提高 EN耐受性，改善病人的机体组成和营养状况，提高病人肌力。
Abstract:
Objective: This study aimed to evaluate the effects of individualized exercise prescription in the nutritional management of patients with late pregnancy related severe acute pancreatitis. Method: A total of 46 SAP patients admitted to the center of SAP, Jinling hospital from January 2016 to July 2020 were selected, of whom 23 patients admitted from January 2016 to December 2017 were assign to the control group, and 23 patients admitted from January 2018 to July 2020 the interventional group. The control group received routine chest physical therapy and limb functional exercise, while the interventional group received individualized exercise prescription. During the implementation of enteral nutrition, enteral nutrition tolerance assessment and management tools were applied every 6 hours in order to promote enteral nutrition. The ICU acquired weakness Medical Research Council score (MRC-score) at 0 d, 3 d, 7 d and 14 d after the implementation of individualized exercise prescription were recorded. The occurrence of feeding intolerance and the enteral nutrition interruption were recorded. The serum total protein, hemoglobin and body mass index were measured at 0 d, 3 d, 7 d and 14 d in all the study subjects. Moreover, total body muscle, skeletal muscle, body fat, trunk water and limbs water were assessed at 0 d, 3 d, 7 d and 14 d. Result: Compared with the control group, the MRC-score was significantly higher on 7 d, 10 d and 14 d in the interventional group (P < 0.05). The differences of serum total protein, hemoglobin and body mass index between the two groups on 7 d and 14 d after intervention were statistically significant (P < 0.05 or P < 0.01). The incidence of feeding intolerance in the interventional group was remarkably lower than that in the control group, especially the incidence of abdominal distension (P < 0.05). The incidence of enteral nutrition interruption in the interventional group was also significantly reduced(P < 0.05). Conclusion: Individualized exercise prescription could promote the absorption and utilization of nutrients, improve the tolerance of enteral nutrition, the body composition and nutritional status of patients, thereby resulting in enhanced muscle strength of patients.

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备注/Memo

备注/Memo:
基金项目 ：军事医学创新工程项目基金（18CXZ040） 作者简介 ：姚红林，主管护师，护理本科，主要从事普通外科危重病临床护理和危重患者人工气道护理。E-mail：1357236687@qq.com 通讯作者 ：叶向红，E-mail：icuyz@126.com
更新日期/Last Update: 1900-01-01