婴幼儿法洛四联症术后肠内营养支持中断的影响因素结构方程模型分析

Structural Equation Model Analysis of Influencing Factors of Enteral Nutritional Support Interruption after Tetralogy of Fallot in Infants

目的:基于结构方程模型分析婴幼儿法洛四联症(TOF)术后发生肠内营养支持中断的影响因素,并提出干预对策。方法:选取阜外华中心血管病医院2021年2月至2023年2月收治的TOF手术患儿86例进行回顾性分析,术后给予肠内营养支持,根据肠内营养支持是否中断分成中断组(50例)、非中断组(36例)。收集两组患儿的基线资料,采用多因素logistic回归模型明确TOF婴幼患儿术后肠内营养支持中断发生的影响因素,并采用结构方程模型进行分析。结果:多因素logistic回归结果显示:喂养不耐受、床边操作次数、管饲故障是TOF婴幼患儿术后肠内营养支持中断发生的独立危险因素(P<0.05)。结构方程模型分析提示,喂养不耐受、床边操作次数、管饲故障对肠内营养支持中断的路径系数(直接效应)分别为0.77、0.64、0.53(均P<0.05)。结论:TOF婴幼患儿肠内营养支持中断发生与喂养不耐受、床边操作次数、管饲故障有关,临床需注意根据情况调整营养支持方案,减少中断次数或缩短中断时间。

Objective To analyze the factors affecting the interruption of enteral nutrition support after tetralogy of Fallot(TOF)in infants and young children based on structural equation model,and to propose intervention strategies.Methods A total of 86 children with TOF surgery admitted to Fuwai Central China Cardiovascular Hospital from February 2021 to February 2023 were selected for retrospective analysis.Postoperative enteral nutrition support was given,and the patients were divided into interrupted group(50 cases)and noninterrupted group(36 cases)according to whether the enteral nutrition support was interrupted.The baseline data of the two groups of children were collected,and the influencing factors of postoperative enteral nutrition support interruption in infants and young children with TOF were identified by multi-factor logistic regression model,and the structural equation model was used for analysis.Results Multivariate logistic regression results showed that feeding intolerance,bedside operation frequency and tube feeding failure were independent risk factors for postoperative enteral nutrition support interruption in infants and young children with TOF(P<0.05).Structural equation model analysis showed that the path coefficients(direct effects)of feeding intolerance,bedside operation times and tube feeding failure on enteral nutritional support interruption were 0.77,0.64 and 0.53(all P<0.05).Conclusion The interruption of enteral nutrition support in infants and young children with TOF is related to feeding intolerance,bedside operation frequency and tube feeding failure.Clinical attention should be paid to adjusting nutrition support program according to the situation to reduce the interruption frequency or shorten the interruption time.