Chinese Journal of Nursing ›› 2019, Vol. 54 ›› Issue (9): 1349-1353.DOI: 10.3761/j.issn.0254-1769.2019.09.013

• Specialist Practice and Research • Previous Articles     Next Articles

Investigation and analysis of factors related to hyperglycemia in ICU patients undergoing enteral nutrition

ZHANG Shan,PANG Xufeng,WAN Xiangyu,LIN Hui,WANG Fengtao()   

  • Received:2018-10-09 Online:2019-09-15 Published:2019-09-19
  • Contact: Fengtao WANG

ICU肠内营养患者高血糖发生现况及影响因素分析

张珊,庞旭峰,万香玉,林辉,王奉涛()   

  1. 266003 青岛市 青岛大学附属医院重症医学科
  • 通讯作者: 王奉涛
  • 作者简介:张珊:女,本科,护师,E-mail:zhangshanicu@163.com

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

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