急性重症胰腺炎患者发生肠内营养不耐受的相关影响因素及其干预措施分析

Analysis of Related Influencing Factors and Intervention Measures of Enteral Nutrition Intolerance in Patients with Acute Severe Pancreatitis

目的:探讨急性重症胰腺炎(SAP)患者发生肠内营养不耐受的相关影响因素及其干预措施。方法:回顾性分析2019年2月-2020年12月赣州市人民医院收治的115例SAP患者的临床资料,分析SAP患者发生肠内营养不耐受的相关影响因素。结果:115例SAP患者,出现肠内营养不耐受62例(53.91%),肠内营养耐受53例(46.09%)。单因素分析显示:APACHEⅡ评分、血糖、添加膳食纤维、腹内、血清白蛋白水平与SAP患者发生肠内营养不耐受均有关,差异均有统计学意义(P<0.05);年龄、性别、pH值、肠内营养开始时间、机械通气与SAP患者发生肠内营养不耐受均无关,差异均无统计学意义(P>0.05)。多因素分析显示:APACHEⅡ评分≥20分、血糖≥11.1 mmol/L、腹内压>15 mmHg、血清白蛋白水平<25 g/L均是SAP患者发生肠内营养不耐受的高危因素(P<0.05),添加膳食纤维是SAP患者发生肠内营养不耐受的保护因素(P<0.05)。结论:SAP患者发生肠内营养不耐受与APACHEⅡ评分、血糖、腹内压、血清白蛋白水平均密切相关,添加膳食纤维是SAP患者发生肠内营养不耐受的保护因素,临床可针对各危险因素加强护理措施干预。

Objective:To investigate the related factors and intervention measures of enteral nutrition intolerance in patients with acute severe pancreatitis (SAP).Method:The clinical data of 115 SAP patients admitted to Ganzhou People’s Hospital from February 2019 to December 2020 were retrospectively analyzed,and the related factors influencing the incidence of enteral nutrition intolerance in SAP patients were analyzed.Result:Among 115 SAP patients,62 cases (53.91%) had enteral nutrition intolerance,and 53 cases (46.09%) had enteral nutrition tolerance.Single factor analysis showed:APACHEⅡ score,blood sugar,added dietary fiber,intra-abdominal and serum albumin levels were all related to enteral nutritional intolerance in SAP patients,and the differences were statistically significant (P<0.05);age,gender,pH,intestinal nutrition start time,mechanical ventilation and enteral nutrition intolerance in SAP patients were not related,and the differences were not statistically significant (P>0.05).Multivariate analysis showed that APACHEⅡ score ≥20 scores,blood glucose ≥11.1 mmol/L,intra-abdominal pressure >15 mmHg,and serum albumin level <25 g/L were all high-risk factors for enteral nutrition intolerance in SAP patients (P<0.05),adding dietary fiber was a protective factor for enteral nutrition intolerance in SAP patients (P<0.05).Conclusion:Enteral nutrition intolerance in SAP patients is closely related to APACHEⅡ score,blood glucose,intra-abdominal pressure,and serum albumin level,adding dietary fiber is a protective factor for enteral nutrition intolerance in SAP patients,clinical nursing intervention can be strengthened according to various risk factors.