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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 修订日期：2024-04-02 |
| DOI： |
| 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:河南省科技攻关项目（232102310235）资助项目 |
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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2022 年1月-2022 年12月期间在我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组和非ICU- AW组,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7d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7d时腹内压等方面具有统计学差异(P<0. 05)；其中ICU-AW组患者肠内营养7d时的腹内压为(16.42 ± 1.52) cmH2O均为高于非ICU- AW组 (12.88±2.19) cmH2O,差异有统计学差异(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7d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7d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,应引起重视并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 on 212 patients receiving first early enteral nutrition in our emergency intensive care unit (EICU) from January 2022 to December 2022. They were divided into 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 at 7 days were recorded for the two groups of patients, then analyse the relationship between intra-abdominal pressure and ICU-AW and explore the factors affecting ICU acquired weakness. Results: There were statistical differences between the two groups in terms of 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 intolerance and abdominal pressure at 7 days of enteral nutrition treatment (P<0. 05)； The intra-abdominal pressure in the ICU-AW group was (16.42 ± 1.52) cmH2O, which was higher than that in the non ICU-AW group (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 intolerance and high abdominal pressure after 7 days of enteral nutrition treatment. Conclusion: Elderly 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 intolerance and high abdominal pressure after 7 days of enteral nutrition treatment are risk factors for ICU-AW in patients undergoing initial enteral nutrition treatment. Attention should be paid to and targeted early intervention should be given. |
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