儿科重症监护病房患儿肠内营养中断的研究

Observational study on enteral nutrition interruption in children in pediatric intensive care unit

目的调查儿科重症监护病房患儿肠内营养中断现状,分析相关影响因素,为患儿肠内营养中断干预措施制定提供参考。方法选取儿童专科医院重症监护病房299例患儿为研究对象,调查患儿肠内营养中断情况及原因。将患儿分为肠内营养中断组与肠内营养未中断组,分析肠内营养中断对患儿临床结局的影响。结果299例患儿发生肠内营养中断190例(63.5%),共373例次,平均每例患儿发生营养中断2.0(1.0,3.0)次,发生营养中断16.0(8.0,29.3)h。喂养不耐受是营养中断最常见的原因;肠内营养中断组患儿机械通气时间、多脏器功能不全、PICU住院时间及PICU住院费用显著高于未中断组(均P<0.05)。结论儿科重症监护病房患儿肠内营养中断发生率高,影响患儿结局。应制定肠内营养中断的干预策略,缩短肠内营养中断时间,减少不必要的肠内营养中断。

Objective To understand the status quo of enteral nutrition interruption(ENI)in children in the pediatric intensive care unit(PICU)and analyze the relevant influencing factors,thereby providing references for the formulation of intervention measures for ENI in children.Methods A total of 299 children from PICU of a specialized children′s hospital were selected as research subjects.Instances of ENI in the children were observed and the causes were probed.Then the children were divided into an ENI group and a non-ENI group to analyze the influence of ENI on clinical outcomes of the children.Results Out of the 299 children,190(63.5%)experienced ENI,amounting to 373 instances in total,with an average of 2.0(1.0,3.0)instances per child and a duration of 16.0(8.0,29.3)hours per interruption.Feeding intolerance was the most common cause for interruption.Children in the ENI group had significantly longer mechanical ventilation duration,higher incidence rate of multi-organ dysfunction,longer PICU stay,and higher PICU hospitalization costs,as compared to the non-EN group(all P<0.05).Conclusion The incidence of ENI in children in the PICU is high and affects their outcomes.Intervention strategies for ENI should be developed to shorten the duration of ENI and reduce unnecessary interruptions.