【摘要】：目的:探討導(dǎo)致入住ICU的創(chuàng)傷患者腸內(nèi)營養(yǎng)(enteral nutrition,EN)喂養(yǎng)不耐受(feeding intolerance,FI)發(fā)生的危險因素。方法:對2013年7月~2015年7月期間入住某三甲醫(yī)院ICU并實施EN的98例創(chuàng)傷患者的病歷資料進行回顧,對EN耐受組與不耐受組患者的年齡、血清白蛋白、血糖、EN開始時間、ISS評分、APACHEⅡ評分、GCS評分以及顱腦損傷、多發(fā)傷、脊髓損傷、骨折、其他傷5種創(chuàng)傷類型進行單因素分析,并將單因素分析結(jié)果中P0.2的指標納入Logistic回歸分析。結(jié)果:單因素分析結(jié)果顯示:血清白蛋白、血糖、EN開始時間、APACHEⅡ評分、GCS評分以及5種創(chuàng)傷類型之間差異有統(tǒng)計學(xué)意義(P0.05),ISS評分P=0.1080.2;Logistic回歸分析結(jié)果顯示:血清白蛋白(OR=0.171,P=0.007,95%CI=0.048~0.616)、血糖(OR=10.493,P=0.001,95%CI=2.534~43.448)、EN開始時間(OR=11.540,P=0.004,95%CI=2.205~60.392)、GCS評分(OR=0.136,P=0.034,95%CI=0.021~0.858)、APACHEⅡ評分(OR=4.361,P=0.037,95%CI=1.096~17.350)是引起創(chuàng)傷患者發(fā)生FI的獨立危險因素;而5種創(chuàng)傷類型中,除其他傷外,多發(fā)傷、脊髓損傷、骨折的患者其FI的發(fā)生率與顱腦傷患者沒有統(tǒng)計學(xué)差異。結(jié)論:患者的血清白蛋白和GCS評分越低、血糖和APACHEⅡ評分越高、EN開始時間越晚,其發(fā)生FI的風險也越大。
[Abstract]:Objective: to investigate the risk factors of enteral nutrition (enteral nutrition,EN) feeding intolerance (feeding intolerance,FI) in traumatic patients admitted to ICU. Methods: the medical records of 98 trauma patients admitted to ICU and EN in a third grade A hospital from July 2013 to July 2015 were reviewed. The age, serum albumin, blood glucose and EN start time of patients in EN tolerance group and non-tolerance group were analyzed. ISS score, Apache II score, GCS score and five trauma types of craniocerebral injury, multiple injury, spinal cord injury, fracture and other injuries were analyzed by univariate analysis, and the index of P0.2 in univariate analysis was included in Logistic regression analysis. Results: the results of univariate analysis showed that there were significant differences in serum albumin, blood glucose, EN start time, Apache II score, GCS score and five types of trauma (P < 0.05), ISS score P 鈮，

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