非糖尿病重症患者管饲肠内营养期间血糖控制现状及其影响因素分析

目的探讨非糖尿病重症患者管饲肠内营养期间血糖控制现状并分析其影响因素.方法选取2019年9月至2020年6月重症监护室(ICU)的重症患者102例.通过电子病例系统对患者信息进行采集,收集患者一般人口学特征、疾病相关特征和血糖控制相关指标.结果102例患者中,入ICU时血糖(8.98±3.13)mmol/L,接受肠内营养第3天血糖(9.52±2.58)mmol/L,两者比较差异有统计学意义(P<0.05).接受肠内营养第3天,高血糖发生率34.31%.血糖标准差(2.12±1.22)mmol/L;血糖变异系数(21.69±8.35)%.多元线性逐步回归分析结果显示,生命支持措施种类数和是否使用胰岛素是非糖尿病重症患者接受肠内营养第3天血糖的影响因素.结论非糖尿病重症患者肠内营养期间高血糖发生率较高,应关注使用生命支持措施种类较多和使用胰岛素患者的血糖,以采取针对性措施提高重症患者血糖管理水平.

Objective To explore the blood glucose control in non-diabetic critical ill patients with enteral nutrition(EN)by tube feeding and analyze its related factors.Methods Using the convenience sampling method,102 critically ill patients in the Intensive Care Unit(ICU)of Zhejiang Provincial People's Hospital from September 2019 to June 2020 were selected as the research objects.The self-designed general survey questionnaire was used to collect patient information through the electronic case system,and the general demographic characteristics of patients,disease-related characteristics and blood glucose control indicators were collected.Results Among 102 patients,the blood glucose when entering the ICU was(8.98±3.13)mmol/L,and the blood glucose 3 days after receiving enteral nutrition was(9.52±2.58)mmol/L with a statistical difference(P<0.05).The incidence of hyperglycemia was 34.31%after receiving enteral nutrition.The standard deviation of blood glucose was(2.12±1.22)mmol/L,and the coefficient of variation of blood glucose was(21.69±8.35)%.The results of multiple linear regression analysis showed that the number of life support measures and the use of insulin were the influencing factors of blood glucose in the first 3 days of non-diabetic patients receiving enteral nutrition.Conclusion The incidence of hyperglycemia of non-diabetic critical ill patients during the enteral nutrition is high,and medical workers should pay attention to patients who use life support measures and insulin to monitor blood glucose abnormalities and further improve blood glucose management in critically ill patients.