间断喂养与持续喂养对行机械通气患者耐受性、营养指标及预后的影响

Effects of intermittent feeding versus continuous feeding on tolerance,nutritional indexes,and prognosis in critically ill patients undergoing mechanical ventilation

目的比较间断喂养与持续喂养对行机械通气的危重患者耐受性、营养指标及预后的影响。方法选取2021年6月至2022年6月于邯郸市中心医院接受机械通气的危重患者100例,并随机分为持续喂养组和间断喂养组,每组各50例。比较两组喂养目标达标情况、喂养耐受情况、机械通气时间及营养指标的差异。营养指标包括前白蛋白(prealbumin,PA)、白蛋白(albumin,ALB)、总蛋白(total protein,TP)、血红蛋白(hemoglobin,Hb)。结果两组喂养第1~6天目标达标率比较,差异无统计学意义(P>0.05);喂养第7天,间断组目标达标率高于持续组(P<0.05);两组喂养耐受性情况和机械通气时间比较,差异无统计学意义(P>0.05);喂养第1天及第7天,两组ALB、PA、Hb水平比较,差异无统计学意义(P>0.05);予肠内营养支持后,第7天两组ALB及Hb均较前升高(P<0.05)。结论机械通气的危重患者早期间断喂养与持续喂养效果相当,提高喂养耐受性是提高喂养效果的关键。

Objective To compare the effects of intermittent feeding versus continuous feeding on the tolerance,nutritional indexes and prognosis of critically ill patients undergoing mechanical ventilation.Methods A total of 100 critically ill patients receiving mechanical ventilation in the Handan Central Hospital from June 2021 to June 2022 were recruited.They were randomly divided into continuous feeding group(50 cases)and intermittent feeding group(50 cases).The compliance rate of nutrition calories,feeding tolerance,mechanical ventilation time and nutritional indexes were compared between the two groups.Nutritional indexes included prealbumin(PA),albumin(ALB),total protein(TP),and hemoglobin(Hb).Results There was no significant difference in the compliance rate of nutrition calories from the 1st to 6th day of feeding(P>0.05).On the 7th day of feeding,the compliance rate of nutrition calories was significantly higher in patients of intermittent feeding group than that of continuous feeding group(P<0.05).There were no significant differences in feeding tolerance and mechanical ventilation time between the two groups(P>0.05).There were no significant difference in ALB,PA and Hb levels on the 1st and 7th day of feeding between the two groups(P>0.05).After enteral nutrition support,ALB and Hb on the 7th day of feeding were significantly enhanced in both groups(P<0.05).Conclusion Early intermittent feeding provides a comparable effect with continuous feeding on critically ill patients with mechanical ventilation.Improving feeding tolerance is the key to improve the feeding effect.