神经内科重症监护病房病人再喂养综合征现状及影响因素研究

Status quo and influencing factors of refeeding syndrome of patients in neurological intensive care unit

目的:调查神经内科重症监护病房(NICU)病人再喂养综合征(RFS)现状,并分析其影响因素。方法:采用便利抽样法,选取2021年1月—2021年10月上海市某三级甲等医院NICU病人作为研究对象,根据病人是否发生RFS分为RFS组(47例)和非RFS组(103例)。采用自制的RFS危险因素筛查表、营养风险筛查量表(NRS-2002)、格拉斯哥昏迷评分(GCS)、序贯器官衰竭评分(SOFA)对病人进行调查。结果:150例病人中47例发生RFS,RFS发生率为31.3%。Logistic回归分析显示,年龄、SOFA评分、颅脑手术、入NICU的48 h内开始喂养、每日蛋白质摄入情况是NICU病人发生RFS的独立影响因素。结论:应从年龄、SOFA评分、颅脑手术等方面对NICU病人进行综合评估,筛选出RFS高危人群,制定个体化的营养治疗方案,预防RFS发生。

Objective:To investigate status quo of refeeding syndrome(RFS)of patients in neurological intensive care unit(NICU)and analyze its influencing factors.Methods:NICU patients in a tertiary grade A hospital in Shanghai were selected as study subjects by convenient sampling method from January 2021 to October 2021.According to whether the patients had RFS or not,they were divided into RFS group(47 cases)and non-RFS group(103 cases).The patients were investigated by self-made RFS risk factor screening form,Nutrition Risk Screening 2002(NRS-2002),Glasgow Coma Scale(GCS)and The Sequential Organ Failure Assessment(SOFA)score.Results:RFS occurred in 47 of 150 patients,and the incidence of RFS was 31.3%.Logistic regression analysis showed that age,SOFA score,craniocerebral surgery,starting feeding within 48 h after admission to NICU,and daily protein intake were independent influencing factors for occurrence of RFS in NICU patients.Conclusions:The NICU patients should be comprehensively evaluated from the aspects of age,SOFA score,craniocerebral surgery and so on,in order to screen out high-risk RFS patients,and formulate individualized nutritional treatment programs to prevent occurrence of RFS.