线粒体基因组测序
·61·
厂房屋顶光伏发电
www.chinagp E-mail:zgqkyx@chinagp ·论著·
蚀刻标牌
陈娅琼，王一婷
【摘要】 目的 探究早期肠内营养幽门后喂养干预应用于危重患者的临床效果。方法 回顾性分析81例危急重症患者临床资料，采用幽门后喂养者纳入幽门后组（n =46），幽门前喂养者纳入幽门前组（n =35）。比较干预前及干预3 d 、1周后两组营养状态［患者自评-主观整体评估（PG-SGA ）］、病情危重程度［急性生理和慢性健康评估系统Ⅱ（APACHE Ⅱ）］变化，分析1周内营养不耐受症状发生率及预后情况差异。结果 干预3 d 、1周后，两组PG-SGA 、APACHE Ⅱ评分均较干预前出现显著下降，且幽门后组明显低于同一时间幽门前组（P <0.05）。干预1周内，幽门后组腹胀、恶心/呕吐、胃潴留发生率均明显低于幽门前组（P <0.05）；而两组腹泻、消化道出血发生率比较，差异均无统计学意义（P >0.05）。干预开始后30 d 内，幽门后组医院获得性肺炎发生率明显低于幽门前组（P <0.05）；而两组泌尿系感染、脓毒性休克、多器官衰竭发生率及病死率比较，差异均无统计学意义（P >0.05）。存活患 者中，幽门后组平均住重症监护病房（ICU ）时间、住院时间均明显少于幽门前组（P <0.05）。结论 采用幽门后喂养能一定程度确保患者营养耐受性与早期肠内营养干预的安全性、有效性，对患者预后康复有积极意义。
【关键词】 危重患者；肠内营养干预；幽门后喂养；营养耐受性；临床预后
【中图分类号】 R 459.3 【文献标识码】 A
Effect of Postpyloric Feeding on Early Enteral Nutrition Tolerance and Clinical Prognosis in Critically Ill Patients CHEN Yaqiong, WANG Yiting
Yiwu Traditional Chinese Medicine Hospital, Yiwu 322000, China
【Abstract 】 Objective To explore the clinical effects of postpyloric feeding in critically ill patients. Methods The clinical data of 81 critically ill patients were retrospectively analyzed. The patients with postpyloric feeding were included in postpyloric group （n =46）, and the patients with prepyloric feeding were included in prepyloric group （n =35）. Nutritional status ［Patient-Generated Subjective Global Assessment （PG-SGA ）］ and severity of illness ［Acute Physiology And Chronic Health Evaluation II （APACHEII ）］ were compared between the two groups before interv
ention and after 3 d and one week of intervention, and the incidence rate of nutrition intolerance symptoms and prognosis were analyzed within one week. Results After 3 d and one week of intervention, the scores of PG-SGA and APACHE II in the two groups were significantly lower than those before intervention, and the scores in postpyloric group were significantly lower than those in prepyloric group at the same time （P <0.05）. Within one week of intervention, the incidence rates of abdominal distension, nausea/vomitin, and gastric retention in postpyloric group were significantly lower than those in prepyloric group （P <0.05）. There were no significant differences in the incidence rates of diarrhea and gastrointestinal bleeding between the two groups （P >0.05）. Within 30 d after the start of intervention, the incidence rate of acquired pneumonia in postpyloric group was significantly lower than that in prepyloric group （P <0.05）. There were no statistically significant differences in the incidence rates of urinary tract infection, septic shock and multiple organ failure and mortality rate between the two groups （P >0.05）. Among the surviving patients, the average intensive care unit （ICU ）stay and hospital stay in postpylorus group were significantly less than those in prepyloric group （P <0.05）. Conclusion Postpyloric feeding can ensure the safety and effectiveness of nutritional tolerance and early
enteral nutrition intervention to a certain extent. It has positive significance for the prognosis and reh
mbr污水处理设备博鼎包达标abilitation of patients. 【Key words 】 Critically ill patients; Enteral nutrition intervention; Postpyloric feeding; Nutrition tolerance; Clinical prognosis 作者单位：322000浙江省义乌市中医医院危重患者往往由于感染、创伤等病因，持续处在严重的
伞齿轮设计
应激状态中，与普通疾病相比营养物质损耗更多，机体分解
lrcp代谢速率加快，且消化系统对营养物质吸收作用削弱，负氮
平衡、营养不良特征尤其突出［1］。持续性的营养不良不仅将
延缓疾病转归，增加住院时间与医疗费用，还可引起患者免疫功能受损，导致病情复杂化［2］，病死率极大增高，所以实施营养干预必要性较大。既往已有较多研究证实，肠内营养支持相较于肠外营养更符合人体营养摄入生理特点，适宜于危重患者生理环境稳态，保护胃肠黏膜结构与功能，有助于有效控制消化液分泌及血糖水平，已成为无绝对禁忌证危重
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