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| 首次早期肠内营养患者发生ICU获得性衰弱的影响因素研究 |
| Study on the factors affecting ICU acquired weakness in patients receiving first early enteral nutrition |
| 投稿时间：2023-08-23 |
| DOI：10.3969/j.issn.1000-0399.2024.04.009 |
| 中文关键词: 危重患者 肠内营养 ICU 获得性衰弱 腹内压 |
| 英文关键词: Critically ill patients Enteral nutrition Intensive care unit acquired weakness Intra abdominal pressure |
| 基金项目:河南省科技发展计划(编号:232102310235) |
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| 中文摘要: |
| 目的 探讨首次早期肠内营养的患者发生ICU获得性衰弱(ICU-AW)的影响因素。方法 对2021年1月至2022年12月期间在河南省人民医院急诊重症监护病房(EICU)进行首次早期肠内营养治疗的212例危重患者进行回顾性研究,根据早期肠内营养治疗期间是否发生ICU-AW分为ICU-AW组(n=76例)和非ICU-AW组(n=136例),记录两组患者的一般资料、早期肠内营养启动时间、热量-蛋白供应量及肠内营养第7天时腹内压值,分析腹内压和ICU-AW的关系,同时探讨发生ICU-AW的影响因素。结果 两组患者在年龄、机械通气、急性生理与慢性健康(APACHEⅡ)评分、血糖、进行肾脏替代治疗、使用皮质类固醇药物、平均每日热卡量、平均每日蛋白量、肠内营养不耐受、肠内营养治疗第7天时腹内压等方面,差异有统计学意义(P<0.05);其中ICU-AW组患者肠内营养第7天时的腹内压为(16.42±1.52) cmH2O均为高于非ICU-AW组(12.88±2.19) cmH2O,差异有统计学意义(P<0.05);logistic回归分析显示:发生ICU-AW的影响因素为年龄大、APACHEⅡ评分高、机械通气、使用皮质类固醇药物、平均每日热卡量及蛋白量低、发生肠内营养不耐受、肠内营养治疗第7天时腹内压高。结论 年龄大、APACHEⅡ评分高、机械通气、使用皮质类固醇药物、平均每日热卡量及蛋白量低、平均每日热卡量及蛋白量低、发生肠内营养不耐受、肠内营养治疗第7天时腹内压高是首次早期肠内营养治疗患者发生ICU-AW的危险因素,应给予有针对性的早期干预。 |
| 英文摘要: |
| Objective To explore the factors affecting intensive care unit acquired weakness(ICU-AW) in patients receiving first early enteral nutrition. Method A retrospective study was conducted on 212 patients who received first early enteral nutrition in the Emergency Intensive Care Unit(EICU) of our hospital from January 2021 to December 2022. The patients were divided into the ICU-AW group and non ICU-AW group based on whether ICU-AW occurred during enteral nutrition treatment. General information, early enteral nutrition initiation time, caloric-protein supply and intra-abdominal pressure values on day 7 of enteral nutrition treatment were recorded for the two groups of patients, then the relationship between intra-abdominal pressure and ICU-AW was analyzed and the factors affecting ICU acquired weakness were explored.Results There were statistical differences between the two groups in age, mechanical ventilation, acute physiological and chronic health(APACHE Ⅱ) scores, blood sugar, renal replacement therapy, corticosteroid use, average daily calorie intake, average daily protein intake, intestinal nutrition intoleranceand abdominal pressure on day 7 of enteral nutrition treatment(P<0.05). The intra-abdominal pressure in the ICU-AW group was higher than that in the non ICU-AW group [(16.42 ± 1.52) cmH2O vs(12.88 ± 2.19) cmH2O], with a statistically significant difference(P<0.05). Logistic regression analysis showed that the risk factors for ICU-AW were age, high APACHE Ⅱ score,mechanical ventilation, use of corticosteroids, low average daily calorie and protein intake, intestinal nutrition intoleranceand high abdominal pressure after seven days of enteral nutrition treatment.ConclusionElderly age, high APACHE Ⅱ score, mechanical ventilation, use of corticosteroids, low average daily calorie and protein levels, low average daily calorie and protein levels, intestinal nutrition intoleranceand high abdominal pressure after seven days of enteral nutrition treatment are risk factors for ICU-AW in patients undergoing initial enteral nutrition treatment. Attention should be paid and targeted early intervention should be given. |
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