ICU肠内营养患者高血糖发生现况及影响因素分析

doi:10.3761/j.issn.0254-1769.2019.09.013

摘要/Abstract

摘要：

目的调查ICU非糖尿病患者肠内营养治疗期间发生高血糖的现状,并探究相关危险因素。方法 2018年1月—9月采用病例对照研究的方式回顾性分析了青岛市某三级甲等医院2个ICU的176例行肠内营养的非糖尿病患者的相关资料,统计并分析患者发生高血糖的现状及危险因素。结果 37例患者发生高血糖,发生率为21.02%。发生高血糖患者与未发生高血糖患者在年龄（OR=1.12）、急性生理与慢性健康状况评分Ⅱ（OR=1.41）、鼻饲速度（OR=1.15）、肠内营养液类型（OR=0.45）、是否进行肠外营养（OR=3.01）、是否使用抗生素（OR=1.77）、是否进行机械通气（OR=7.16）、是否手术（OR=43.99）、输注途径（OR=6.11）等方面差异有统计学意义（P<0.05）。结论年龄、急性生理与慢性健康状况评分Ⅱ升高、鼻饲速度加快、输注短肽或单体型肠内营养液、进行肠外营养、进行机械通气、手术、应用鼻肠管是ICU非糖尿病患者肠内营养治疗期间发生高血糖的危险因素。

关键词: 重症监护, 肠内营养, 高血糖, 护理

Abstract:

Objective To investigate the status of hyperglycemia during enteral nutrition therapy in non-diabetic ICU patients and explore the related risk factors.Methods Relevant information of 176 non-diabetic patients who received enteral nutrition from January 2018 to September 2018 in two ICUs of a tertiary hospital in Qingdao was retrospectively analyzed adopting case control study design.Results Thirty-seven patients developed hyperglycemia,and the incidence was 21.02%. Patients with and without hyperglycemia were statistically different in age（OR= 1.12）,APACHE Ⅱ score（OR=1.41）,nasal feeding speed（OR=1.15）,the type of nutrient solution（OR=0.45）,parenteral nutrition（OR=3.01）,antibiotics（OR=1.77）,mechanical ventilation（OR=7.16）,surgery（OR=43.99）,and feeding pathway（OR=6.11）.Conclusion Age,higher APACHE Ⅱ score,increased nasal feeding speed,short peptide and haplotype enteral nutrient solution,parenteral nutrition,mechanical ventilation,surgery,application of nasointestinal tube are risk factors of hyperglycemia during enteral nutrition therapy in non-diabetic ICU patients.

Key words: Intensive Care, Enteral Nutrition, Hyperglycemia, Nursing Care

张珊, 庞旭峰, 万香玉, 林辉, 王奉涛. ICU肠内营养患者高血糖发生现况及影响因素分析[J]. 中华护理杂志, 2019, 54(9): 1349-1353.

ZHANG Shan, PANG Xufeng, WAN Xiangyu, LIN Hui, WANG Fengtao. Investigation and analysis of factors related to hyperglycemia in ICU patients undergoing enteral nutrition[J]. Chinese Journal of Nursing, 2019, 54(9): 1349-1353.

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