危重症患者管饲依赖症状变化轨迹及影响因素研究

doi:10.3761/j.issn.0254-1769.2026.06.006

中华护理杂志 ›› 2026, Vol. 61 ›› Issue (6): 761-767.DOI: 10.3761/j.issn.0254-1769.2026.06.006

危重症患者管饲依赖症状变化轨迹及影响因素研究

王敏¹(), 纪亚楠², 曹芳³, 聂臣聪¹, 陈瑶¹, 张继权⁴, 陈志美⁵, 杜金磊¹^,^*()

1.自贡市第四人民医院重症医学科四川省自贡市 643000
2.湖州师范学院护理学院浙江省湖州市 313000
3.川北医学院护理学院南充市 637000
4.德阳市人民医院护理部四川省德阳市 618000
5.贵州中医药大学第二附属医院护理部贵阳市 550000

收稿日期:2025-10-09 出版日期:2026-03-20 发布日期:2026-03-23
*通讯作者: 杜金磊，E-mail：dujinlei1128@163.com
作者简介:王敏：女，本科，主管护师，E-mail：574848446@qq.com
基金资助:
四川省护理学会护理科研课题计划(H24049)

Exploring trajectories of tube-feeding dependence symptoms and their determinants in critically ill patients：a longitudinal study

WANG Min¹(), JI Yanan², CAO Fang³, NIE Chencong¹, CHEN Yao¹, ZHANG Jiquan⁴, CHEN Zhimei⁵, DU Jinlei¹^,^*()

1. Department of Critical Care Medicine，Zigong Fourth People’s Hospital，Zigong，Sichuan Province 643000，China
2. Nursing School of Huzhou University，Huzhou，Zhejiang Province 313000，China
3. Nursing School of North Sichuan Medical College，Nanchong 637000，China
4. Department of Nursing，Deyang People’s Hospital，Deyang，Sichuan Province 618000，China
5. Department of Nursing，the Second Affiliated Hospital of Guizhou University of Traditional Chinese Medicine，Guiyang 550000，China

Received:2025-10-09 Online:2026-03-20 Published:2026-03-23
Funding program:
Nursing Research Project Plan of Sichuan Nursing Association(H24049)

摘要/Abstract

摘要：

目的探讨危重症患者肠内营养治疗后管饲依赖症状的变化轨迹及其影响因素，为临床护理实践提供参考。方法采用纵向研究设计，运用便利抽样法，选取四川省自贡市某三级甲等综合医院重症医学科2025年6—9月停止管饲喂养的245例危重症患者为调查对象。在管饲结束当天、第5天、第15天使用危重症患者肠内营养治疗管饲依赖评估量表进行测量。采用增长混合模型识别潜在轨迹类型，并运用多元Logistic回归分析影响因素。结果最终回收有效问卷229份。管饲依赖症状可分为3类轨迹：症状持续高危组（36.68%）、症状快速缓解组（47.16%）、症状低危良好组（16.16%）。多元Logistic回归分析结果显示，年龄、管饲进食天数及是否合并慢性消化系统疾病为影响危重症患者管饲依赖症状变化轨迹类别的主要因素（均P<0.05）。结论危重症患者管饲依赖症状存在3种变化轨迹，并且存在着群体异质性，护理人员应根据不同的症状轨迹对患者进行针对性护理干预。

关键词: 肠内营养治疗, 管饲依赖症状, 症状发展轨迹, 危重症护理

Abstract:

Objective To investigate the developmental trajectories of tube-feeding dependence symptoms after enteral nutrition therapy in critically ill patients and to identify the influencing factors. Methods A longitudinal study was conducted using convenience sampling. 245 critically ill patients who discontinued tube feeding in the Department of Critical Care Medicine of a tertiary general hospital in Zigong，Sichuan Province，between June and September，2025 were assessed using the Tube-Feeding Dependence Symptom Scale on the day of tube-feeding cessation （T1），day 5 （T2），and day 15 （T3）. Latent growth mixture modeling was employed to identify trajectory classes，and multinomial logistic regression was used to analyze the associated factors. Results A total of 229 valid cases were included. Totally 3 distinct symptom trajectories were identified：persistently high-risk group（36.68%），rapid-symptom-resolution group （47.16%），and low-risk favorable group （16.16%）. Older age，longer duration of tube feeding，and comorbid chronic digestive diseases were significant predictors of trajectory class membership（all P<0.05）. Conclusion Critically ill patients exhibit 3 distinct trajectories of tube-feeding dependence symptoms，with notable inter-individual heterogeneity. Nurses should tailor interventions to each patient’s specific trajectory.

Key words: Enteral Nutrition Therapy, Tube-Feeding Dependence Symptoms, Symptoms Developmental Trajectory, Critical Care

王敏, 纪亚楠, 曹芳, 聂臣聪, 陈瑶, 张继权, 陈志美, 杜金磊. 危重症患者管饲依赖症状变化轨迹及影响因素研究[J]. 中华护理杂志, 2026, 61(6): 761-767.

WANG Min, JI Yanan, CAO Fang, NIE Chencong, CHEN Yao, ZHANG Jiquan, CHEN Zhimei, DU Jinlei. Exploring trajectories of tube-feeding dependence symptoms and their determinants in critically ill patients：a longitudinal study[J]. Chinese Journal of Nursing, 2026, 61(6): 761-767.

图/表 4

表1 调查对象一般资料及不同发展轨迹类型的单因素分析

Table 1 Univariate analysis of demographic and disease-related characteristics among patients with different trajectory types

表2 危重症患者管饲依赖症状发展轨迹模型拟合指标

Table 2 Model fit indices for trajectories of tube-feeding dependence symptoms of critically ill patients

图1 管饲依赖症状潜在类别发展轨迹图注：为症状持续高危组；为症状快速缓解组；为症状低危良好组。T1为管饲结束当天，T2为管饲结束第5天，T3为管饲结束第15天。

Figure 1 Latent class trajectories of tube-feeding dependence symptoms

表3 危重症患者管饲依赖症状发展轨迹类别的多元Logistic回归分析结果（n=229）

Table 3 Multinomial logistic regression analysis of factors associated with tube-feeding dependence symptom trajectory classes of critical ill patients（n=229）

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危重症患者管饲依赖症状变化轨迹及影响因素研究

Exploring trajectories of tube-feeding dependence symptoms and their determinants in critically ill patients：a longitudinal study

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