普外科重症患者肠内营养中断影响因素分析及对预后影响的研究

Analysis of influencing factors of enteral nutrition interruption in critically ill patients in general surgery department and its impact on prognosis

目的调查普外科重症患者肠内营养中断影响因素以及肠内营养中断对普外科重症患者预后的影响。方法采用便利抽样法,选取2021年6月至2022年3月就诊于中国人民解放军东部战区总医院普外科的91例重症患者为研究对象,收集患者的一般资料和肠内营养中断相关资料,将患者分为肠内营养中断组与肠内营养未中断组,通过Logistic回归分析肠内营养中断的影响因素,并分析肠内营养中断对普外科重症患者预后的影响。结果肠内营养中断组59例,肠内营养未中断组32例。2组患者性别、镇静镇痛药、促胃动力药、喂养不耐受方面比较差异有统计学意义(χ2值为4.51~9.97,均P<0.05)。Logistic回归分析显示,性别(OR=4.566,95%CI 1.332~15.657,P<0.05)、镇静镇痛药(OR=3.437,95%CI 1.112~10.621,P<0.05)、喂养不耐受(OR=4.116,95%CI 1.257~13.479,P<0.05)是普外科重症患者肠内营养中断的影响因素。2组患者肠内营养前3 d达标天数、4~7 d达标天数、前7 d达标天数、白蛋白、ICU住院时间、总住院时间、住院费用比较差异有统计学意义(Z值为-2.80~-0.73,均P<0.05)。结论女性、使用镇静镇痛药、喂养不耐受是普外科重症患者肠内营养中断的危险因素,以及肠内营养中断对预后有不利影响,临床医护人员应避免过量使用镇静镇痛药物,同时做好耐受性管理减少肠内营养中断事件的发生。

Objective Analysis of influencing factors of enteral nutrition interruption in critically ill patients in general surgery department and its impact on prognosis.Methods A total of 91 cases of critically ill patients in general surgery department were selected who were admitted to the general surgery of General Hospital of Eastern Theater Command of the Chinese People′s Liberation Army in Nanjing from June 2021 to March 2022 by convenient sampling method,demographic and enteral nutrition interruption data were collected,and patients were divided into enteral nutrition interruption group and enteral nutrition uninterrupted group to investigate the analysis of the factors of affecting enteral nutrition interruption and its impact on prognosis by Logistic regression analysis.Results There were 59 cases in the enteral nutrition interruption group and 32 cases in the enteral nutrition uninterrupted group.There were statistically significant differences in gender,analgesic and sedatives,Gastro-kinetic agent and feeding intolerance between both groups(χ2 values were 4.51-9.97,all P<0.05).Logistic regression analysis results showed that gender(OR=4.566,95%CI 1.332-15.657,P<0.05),analgesic and sedatives(OR=3.437,95%CI 1.112-10.621,P<0.05),and feeding intolerance(OR=4.116,95%CI 1.257-13.479,P<0.05)were the factors of enteral nutrition interruption.There were statistically significant differences between the two groups in the number of days of enteral nutrition up to goal in 3 days,3-7 days and 7 days,albumin,length of stay in intensive care unit,total length of stay and hospitalization expenses between both groups(Z values were-2.80--0.73,all P<0.05).Conclusions Female,analgesic and sedatives and feeding intolerance are the risk factors of enteral nutrition interruption in critically ill patients in general surgery department,and enteral nutrition interruption has an adverse impact on the prognosis.Medical staff should avoid excessive use of analgesic and sedatives,and do well in feeding tolerance management to reduce the occurrence of enteral nutrition interruption.