联合序贯肠内营养支持治疗在ICU机械通气患者中的应用价值和安全性

Application value and safety of combined sequential enteral nutrition support therapy in patients with mechanical ventilation in ICU

目的探讨联合序贯肠内营养支持治疗在ICU机械通气患者中的应用价值和安全性。方法选取2019年1月~2020年6月北京市门头沟区医院收治的80例需要机械通气的重症患者作为研究对象,按照抽签法随机分为对照组(40例)和干预组(40例)。对照组应用整蛋白型肠内营养混悬液进行治疗,干预组应用短肽型肠内营养混悬液与整蛋白型肠内营养混悬液联合序贯肠内营养支持治疗。比较两组的营养指标[血红蛋白(Hb)、血清白蛋白(ALB)、氮平衡(NE)、上臂肌围(MAMC)与肱二头肌的皮皱厚度(TSF)]、恢复效果[营养的达标率、免疫球蛋白G(IgG)、住院时间]及不良反应发生情况。结果干预后,干预组的Hb、ALB、MAMC、TSF等营养指标水平均高于对照组,差异有统计学意义(P<0.05);干预组的IgG水平与营养达标率均高于对照组,差异有统计学意义(P<0.05);干预组住院时间短于对照组,差异有统计学意义(P<0.05);干预组的反流、腹泻、腹胀等不良反应发生率均低于对照组,差异有统计学意义(P<0.05)。结论机械通气的ICU患者应用短肽型营养液与整蛋白型营养注进行联合序贯肠内营养支持治疗的效果显著,能提升其营养水平,减少不良反应,促进患者康复,缩短了住院时间,安全性高,值得推广应用。

Objective To investigate the application value and safety of combined sequential enteral nutrition support therapy in patients with mechanical ventilation in ICU.Methods A total of eighty cases of severe patients requiring mechanical ventilation who admitted to Beijing Mentougou District Hospital from January 2019 to June 2020 were selected as the research objects,and randomly divided into the control group(40 cases)and the intervention group(40 cases)according to the random drawing method.The control group was treated with enteral nutrition suspension of integrin type,while the intervention group was treated with combined sequential enteral nutrition support of enteral nutrition suspension of short peptide type and enteral nutrition suspension of integrin type.The nutritional indicators(hemoglobin[Hb],serum albumin[ALB],nitrogen balance[NE],upper arm muscle circumference[MAMC]and biceps skin wrinkle thickness[TSF]),recovery effect(nutrition compliance rate,immunoglobulin G[IgG],length of hospital stay)and occurrence of adverse reactions were compared between the two groups.Results After the intervention,the levels of Hb,ALB,MAMC,TSF and other nutritional indicators in the intervention group were higher than those in the control group,with statistically significant differences(P<0.05);the IgG level and nutritional compliance rate in the intervention group were higher than those in the control group,with statistically significant differences(P<0.05);the length of hospital stay in the intervention group was shorter than that in the control group,with statistically significant difference(P<0.05);the incidence rates of adverse reactions such as reflux,diarrhea and abdominal distension in the intervention group were all lower than those in the control group,with statistically significant differences(P<0.05).Conclusion In ICU patients with mechanical ventilation,the combined sequential enteral nutrition support therapy of short peptide nutrition solution and whole protein nutrition solution has a significant effect,which can improve their nutritional levels,reduce adverse reactions,promote patients′recovery and shorten the length of hospital stay,has high safety,and is worthy of popularization and application.