【摘要】：目的探討嚴(yán)重?zé)齻颊吣c內(nèi)營養(yǎng)不耐受的影響因素及與預(yù)后的相關(guān)性。方法收集62例嚴(yán)重?zé)齻颊叩呐R床資料,根據(jù)患者對(duì)腸內(nèi)營養(yǎng)耐受與否分為耐受組和不耐受組,比較兩組的臨床特征和預(yù)后,分析發(fā)生腸內(nèi)營養(yǎng)不耐受的影響因素。結(jié)果 62例患者中,不耐受組37例(59.7%),耐受組25例(40.3%)。與耐受組比較,不耐受組熱卡達(dá)標(biāo)率和熱氮比達(dá)標(biāo)率均顯著降低(P0.05),第28天前白蛋白水平顯著降低(P0.05),而肺炎、感染性休克和多臟器功能障礙綜合征的發(fā)生率均顯著升高(P0.05),病死率顯著升高(P0.05)。多因素logistic回歸分析顯示,燒傷總面積較大、高APACHEⅡ評(píng)分、低蛋白、使用升壓藥、手術(shù)次數(shù)多是燒傷患者發(fā)生腸內(nèi)營養(yǎng)不耐受的獨(dú)立危險(xiǎn)因素。結(jié)論嚴(yán)重?zé)齻颊甙l(fā)生腸內(nèi)營養(yǎng)不耐受的比例較高,腸內(nèi)營養(yǎng)不耐受與患者營養(yǎng)不良、并發(fā)癥和預(yù)后不佳有關(guān)。
[Abstract]:Objective to investigate the influential factors of enteral nutrition intolerance in patients with severe burn and its correlation with prognosis. Methods the clinical data of 62 patients with severe burn were collected and divided into tolerance group and intolerance group according to their tolerance to enteral nutrition. The clinical characteristics and prognosis of the two groups were compared and the influencing factors of enteral nutrition intolerance were analyzed. Results of the 62 patients, 37 (59.7%) were in intolerance group and 25 (40.3%) in tolerance group. Compared with the tolerance group, the heat-to-nitrogen ratio and the heat-to-nitrogen ratio in the intolerance group were significantly lower than those in the tolerance group (P0.05), and the albumin level before 28th day was significantly lower than that in the control group (P0.05), while pneumonia was significantly lower than that in the intolerance group. The incidence of septic shock and multiple organ dysfunction syndrome was significantly higher (P0.05) and mortality was significantly higher (P0.05). Multivariate logistic regression analysis showed that large total burn area, high APACHE 鈪，

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