俯卧位通气患者肠内营养耐受性的影响因素分析

Analysis of factors affecting enteral nutrition tolerance in patients accepting prone position ventilation

目的探讨俯卧位通气治疗患者肠内营养耐受性的影响因素。方法采用回顾性研究的方法分析2013年1月~2018年12月行俯卧位通气(PPV)患者肠内营养的耐受情况,分别以单因素和多因素方法分析俯卧位通气患者肠内营养耐受性的影响因素。结果符合纳入标准的患者92例,根据肠内营养耐受表将所有患者分为2组:耐受性好的患者45例,耐受性差的患者47例。单因素分析显示年龄、是否使用肌松药、白蛋白、前白蛋白、单位时间喂养量、急性生理与慢性健康评分(APACHEⅡ)、序贯器官衰竭评分(SOFA)、危重患者营养风险评分(NUTRIC)和胃残余量是影响俯卧位过程患者肠内营养耐受性的因素(P<0.05)。Logistic分析显示影响俯卧位过程患者肠内营养耐受性的因素分别为年龄、是否使用肌松药、白蛋白、前白蛋白、APACHEⅡ、SOFA和NUTRIC评分(P<0.05)。结论影响俯卧位过程患者肠内营养耐受性的因素分别为年龄、是否使用肌松药、白蛋白、前白蛋白、APACHEⅡ、SOFA和NUTRIC评分。

Objective To investigate the factors affecting enteral nutrition tolerance in patients accepting prone position ventilation.Methods A retrospective study was conducted to analyze the tolerance of enteral nutrition in patients with prone position ventilation from January 2013 to December 2018.The single factor and multiple factors were used to analyze the influencing factors of enteral nutrition tolerance in patients accepting prone position ventilation.Results Ninety-two patients who met the inclusion criteria were divided into 2 groups according to enteral nutrition tolerance table:45 patients with good tolerance and 47 patients with poor tolerance.Univariate analysis showed age,use of muscle relaxants,albumin,prealbumin,feeding amount per unit time,acute physiology and chronic health evaluationⅡ(APACHEⅡ),sequential organ failure assessment(SOFA),nutrition risk in critically ill(NUTRIC)score and gastric residual volume were factors affecting the patient’s tolerance(P<0.05).Logistic analysis showed that the factors affecting the patient’s tolerance during the prone position were age,use of muscle relaxant,albumin,prealbumin,APACHEⅡ,SOFA,and NUTRIC scores(P<0.05).Conclusion Factors affecting enteral nutrition tolerance in patients accepting prone position ventilation are age,use of muscle relaxants,albumin,prealbumin,APACHEⅡ,SOFA and NUTRIC scores.