ICU患者早期肠内营养耐受性监测系统的构建与应用

doi:10.3761/j.issn.0254-1769.2022.07.001

摘要/Abstract

摘要：

目的构建ICU患者早期肠内营养耐受性监测系统,探讨其应用效果。方法对肠内营养耐受性评分表进行修订,并以此为基础构建ICU患者早期肠内营养耐受性监测系统,实时采集相关数据。采用便利抽样法,选取2021年6月—8月浙江省某三级甲等医院ICU收治的60例行早期肠内营养的患者作为试验组,使用该监测系统对其肠内营养的耐受性进行评估;将2021年3月—5月收治的60例患者作为对照组,使用修订前的肠内营养耐受性评分表进行评估,根据评估结果调整两组肠内营养方案。比较两组肠内营养7 d内喂养不耐受发生率、目标喂养量达标率,肠内营养第1天与第8天白蛋白、血清总蛋白、血红蛋白浓度的差值,收集护士对该监测系统的满意度。结果试验组喂养不耐受发生率低于对照组,目标喂养量达标率高于对照组,肠内营养第8天与第1天白蛋白、血清总蛋白、血红蛋白浓度的差值高于对照组,差异均具有统计学意义（P<0.05）。护士对该监测系统的满意度评分为（4.51±0.31）分。结论使用ICU患者早期肠内营养耐受性监测系统有助于降低患者喂养不耐受的发生率,提高目标喂养量达标率,改善患者的营养状况,护士对该监测系统的满意度较高。

关键词: 重症监护病房, 早期肠内营养, 耐受性, 信息系统, 护理

Abstract:

Objective To construct an early enteral nutrition tolerance monitoring system for ICU patients and to apply it into the practice. Methods The enteral nutrition tolerance score table was revised,and on this basis,the early enteral nutrition tolerance monitoring system of ICU patients was constructed to collect relevant data in real time. Using the convenient sampling method,120 patients with early enteral nutrition treated in ICU of a tertiary A hospital in Zhejiang Province from March to August 2021 were selected as the research subjects. The monitoring system was used to evaluate the tolerance to enteral nutrition of the experimental group;the revised enteral nutrition tolerance rating scale was used to evaluate the control group;the enteral nutrition scheme was dynamically adjusted according to the evaluation results. The incidence of feeding intolerance within 7 days of enteral nutrition,the target feeding rate,and the difference of albumin,serum total protein and hemoglobin concentrations between the 8th day and the 1st day of enteral nutrition were compared between the 2 groups,and the nurses’ satisfaction with the monitoring system was collected. Results The incidence of feeding intolerance in the experimental group was lower than that in the control group;the target feeding rate was higher than that in the control group;the difference of albumin,serum total protein and hemoglobin concentrations between the 8th day and the 1st day of enteral nutrition was higher than that in the control group（P<0.05）. The total average score of nurses’ satisfaction with the monitoring system was（4.51±0.31）. Conclusion The use of early enteral nutrition tolerance monitoring system for ICU patients can effectively reduce the incidence of early enteral nutrition intolerance,improve the target feeding rate and improve the nutritional status of patients. Nurses are highly satisfied with the monitoring system.

Key words: Intensive Care Units, Early Enteral Nutrition, Tolerance, Information System, Nursing Care

全殷殷, 张帅, 陈娟红, 刘飞跃, 姚惠萍. ICU患者早期肠内营养耐受性监测系统的构建与应用[J]. 中华护理杂志, 2022, 57(7): 773-778.

QUAN Yinyin, ZHANG Shuai, CHEN Juanhong, LIU Feiyue, YAO Huiping. Construction and application of early enteral nutrition tolerance monitoring system for ICU patients[J]. Chinese Journal of Nursing, 2022, 57(7): 773-778.

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