营养支持小组对ICU患者营养支持状况的影响

Effect of nutrition support team on ICU patients nutritional support conditions

目的探讨营养支持小组(NST)对ICU患者营养支持方式及并发症的影响。方法将268例ICU患者以NST建立时为界,建立前为A组,建立后为B组。对两组患者的营养支持状况及并发症进行对照分析。结果B组有规范营养监测、采用全胃肠内营养(TEN)方式、肠外营养采用"全合一"方式的比例较A组显著提高(P<0.01,P<0.05),而采用全胃肠外营养(TPN)方式、不恰当静脉营养支持的比例显著下降(P<0.05,P<0.01);B组白蛋白的输注量显著减少(P<0.01);血清白蛋白≤30g/L的低蛋白血症、胃肠道并发症、代谢并发症、在ICU死亡的发生率均较A组显著下降(P<0.01,P<0.05)。结论NST使综合ICU营养支持的规范化程度提高,显著降低营养支持相关并发症的发生率,使危重患者获得合理、安全、有效的营养支持。

Objective To investigate the effect of NST on the ICU patients nutritional support ways and complications. Methods 268 ICU patients were divided into group A （before the establishment）and group B（after the establishment）. Cross-check analysis on the nutritional support conditions and complications was made. Results The proportions of standard nutrition monitor, the way of TEN and ＂all in one＂ of PN in group B significantly increased（ P 〈 0.01, P 〈 0.05）, while those of the way of TPN, inappropriate PN nutrition proportions largely decreased（ P 〈 0. 01 ） ; ALB infusions was remarkably reduced （ P 〈 0.01 ）. When compared with that of group A, the hypoproteinemia of ALB≤ 30 g/L, gastrointestinal complications, metabolism complications and death rate in ICU in group B dropped remarkably （ P 〈 0.01, P 〈 0.05）. Conclusion NST can improve the standardization of synthetic ICU nutrition support, remarkably decrease the incidence of related complications and ensure the critical patients to obtain reasonable, safe and effective nutrition support.