住院患者肠外营养支持时间的相关因素回顾性研究

Analysis of influencing factors on duration of parenteral nutrition in hospitalized patients

目的分析住院患者接受肠外营养（PN）支持时间的影响因素。方法收集接受PN治疗（≥3 d）住院患者的临床资料。记录患者一般情况（年龄、性别、身高、体质量、入院诊断及是否有手术、机械通气和慢性病病史）、血生化指标（PN前血常规、血糖、血脂、肝肾功能、血钙、血磷、血镁指标）和PN相关指标（PN时间、PN输注时微循环血糖、日均蛋白质和能量供给量）。目标供给量依据Schofield公式计算。结果共收集643例接受PN治疗住院患者的临床资料,其中男性423例,女性220例。接受PN时间的中位数为8 d（3~370 d）,其中全禁食者占72.8%。多因素方差分析结果显示：心血管疾病史、机械通气、血γ谷氨酰转肽酶（γ-GT）水平和PN期间日均能量供给（〈75%目标剂量）是PN支持时间的影响因素。结论具有心血管疾病病史、使用机械通气、血γ-GT升高和PN日均能量供给较低使PN支持时间延长。

Objective To analyze influencing factors on duration of parenteral nutrition（PN） in hospitalized patients.Methods The clinical data of hospitalized patients who received PN for more than 3 d were collected.General information（age,gender,height,body weight,diagnosis,surgery,mechanical ventilation,and chronic metabolic diseases）,blood biochemical indexes（blood routine,fast blood sugar,liver function,kidney function,calcium,phosphorus,magnesium before PN）,and PN related indexes（duration,blood sugar when infusion of PN,daily calorie and protein supplementation） were recorded and the calorie goal was calculated by Schofield equation.Results The clinical data of 643 hospitalized patients who received PN were collected.Among them,423 were males and 220 were females.The median duration of PN was 8 d（3-370 d）and 72.8%of patients underwent total fasting.The results of multivariate variance analysis showed that history of cardiovascular diseases,mechanical ventilation,blood gamma glutamyl transpeptidase level,and average daily calorie supplement（〈75%energy goal） were influencing factors of PN duration.Conclusion Cardiovascular diseases,mechanical ventilation,high gamma glutamyl transpeptidase level,and low average daily calorie supplement can lengthen the PN duration.