肠内营养耐受处理SOP对重症病房机械通气患者营养指标及并发症的影响

The effect of enteral nutrition tolerance SOP on nutritional index and complications of patients with mechanical ventilation in severe disease area

目的:探讨肠内营养(EN)耐受处理标准化流程(SOP)对重症病房机械通气患者临床效果的影响。方法:选取2018年1月~2019年12月收治的63例需长期机械通气的患者,分为常规组31例和干预组32例,两组患者均给予常规EN治疗方案及常规对症支持治疗,而干预组患者行EN耐受处理SOP。干预1个月后,比较两组患者治疗前后营养指标,对比两组EN耐受及预后情况。结果:两组干预1个月后血清PA、Hb及Alb水平均显著升高,差异有统计学意义(P<0.01),且干预组高于常规组,差异有统计学意义(P<0.01)。与常规组相比,干预组胃肠道动力药物使用量及EN中断时间均显著减少,差异有统计学意义(P<0.01),且消化道出血发生率更低,差异有统计学意义(P<0.05)。干预组VAP发生率显著降低,差异有统计学意义(P<0.05),且未出现病死,此外,与常规组相比,干预组ICU住院时间更低,差异有统计学意义(P<0.01)。结论:采用EN耐受处理SOP管理后,患者营养状况更优,耐受更佳,预后更好。

Objective To explore the effect of standardized procedure(SOP)of EN tolerance on nutritional indexes and complications of mechanical ventilation patients in ICU.Method 63 patients who needed long-term mechanical ventilation from January 2018 to December 2019 were recruited and divided into routine group(31 cases)and intervention group(32 cases).Both groups were given routine enteral nutrition treatment plan and routine symptomatic support treatment,while intervention group patients were given enteral nutrition tolerance SOP.After one month of intervention,nutritional indicators before and after treatment were compared between the two groups,and enteral nutrition tolerance and prognosis of the two groups were compared.Results The levels of PA,Hb and ALB in the two groups were significantly higher than those in the control group,the intervention group was higher than the routine group,and the difference was statistically significant(P<0.01).Compared with the routine group,the dosage of gastrointestinal motility drugs and enteral nutrition interruption time in the intervention group were significantly reduced(P<0.01),and the incidence of gastrointestinal bleeding was lower(P<0.05).The incidence of VAP in the intervention group was significantly reduced(P<0.05),and there was no mortality.In addition,compared with the routine group,the length of stay in ICU in the intervention group was lower(P<0.01).Conclusion The nutritional status,tolerance and prognosis of patients were better after EN tolerance SOP management.