影响重症医学科患者肠内营养期间发生腹泻的有关因素分析

Analysis of Related Factors of Diarrhea in Patients with Intensive Care Unit during Enteral Nutrition

目的探讨重症医学科(ICU)患者肠内营养(EN)期间影响患者腹泻发生的相关因素。方法回顾性收集宣城市人民医院重症医学科2015年5月至2016年10月实施肠内营养患者的相关资料,统计分析EN期间腹泻发生情况及其影响因素。结果 108例实施EN的患者中,有61例(56.5%)患者发生腹泻。其中有50例(82.0%)患者在实施EN第1周内发生腹泻。单因素分析表明,EN制剂日用量、EN实施天数、EN制剂逐渐增量、EN前一天用非EN制剂输注、EN前禁食、禁食天数、口服钾制剂与腹泻发生有关。多因素分析表明,EN制剂日用量、EN实施天数、EN前禁食、钾制剂是患者肠内营养期间腹泻发生的危险因素。而EN制剂逐渐增量输注方式以及EN前一天用非EN制剂输注能够显著减少腹泻的发生。结论 ICU患者EN期间腹泻发生率较高,其发生与多种因素有关,且多发生于EN早期。应密切关注高危人群,采取积极措施消除或减轻危险因素。

Objective To investigate the factors affecting diarrhea in patients with intensive care unit （ICU） during Enteral Nutrition （EN）. Methods The data of patients with enteral nutrition from May,2015 to October,2016 in Xuancheng Peoples Hospital were collected retrospectively. The incidence of diarrhea during EN and its influencing factors were analyzed statistically. Results Of the 108 patients enrolled in EN ,61 （56. 5%） had diarrhea. Fifty （82. 0% ） of these patients developed diarrhea during the first week of EN. Uni-variate analysis showed that the daily dosage of EN preparation, the number of days of EN implementation, the increment of EN preparation,EN injection the day before,EN fasting,fasting days,oral potassium preparations and diarrhea. Multivariate analysis indicated that the risk factors for diarrhea were EN daily dosage, days of en-forcing EN,fasting and potassium preparations before EN. EN infusion was gradually increased,infusion of non- EN preparation was the protective factor before EN. Conclusion The incidence of diarrhea is high in EN pa-tients, and the occurrence of ICU is related to many factors. Nursing should pay close attention to high-risk groups,and active measures should be taken to eliminate or reduce risk factors.