Abstract:

Objective To investigate the status of refeeding syndrome during enteral nutrition therapy in ICU patients and to explore the influencing factors. Methods The convenience sampling was adopted,and relevant clinical information of 433 patients who received enteral nutrition from January 2018 to July 2020 in ICU of a tertiary hospital in Zhejiang was retrospectively analyzed. The patients were divided into a refeeding syndrome group and a non-refeeding syndrome group. Results 130 patients developed refeeding syndrome,and the incidence was 30.02%.Logistic regression analysis showed that patients with and without refeeding syndrome were statistically different（P<0.05）in Nutritional Risk Screening 2002（OR=5.504）,albumin（OR=2.295）,prealbumin（OR=2.957）,history of diabetes（OR=2.536）,feeding route（OR=2.323）,temperature of the nutrition liquid（OR=2.271）,protein intake（OR=3.270）,calorie intake（OR=3.965）and feeding speed（OR=2.735）. Conclusion Nutritional Risk Screening 2002≥3,lower albumin,lower prealbumin,history of diabetes,nasointestinal feeding,higher temperature of the nutrition liquid,higher protein intake,higher calorie intake and faster feeding speed are influencing factors of refeeding syndrome during enteral nutrition therapy in ICU patients. It is necessary for nurses to pay attention to the factors and take a control of them.

Key words: Critical Illness, Enteral Nutrition, Refeeding Syndrome, Root Cause Analysis, Nursing Care

摘要：

目的 调查ICU肠内营养患者再喂养综合征发生现状,并分析其影响因素。方法 采取便利抽样法,回顾性收集2018年1月—2020年7月浙江省某三级甲等医院ICU收治的433例患者的临床资料,根据是否发生再喂养综合征分为再喂养综合征组和非再喂养综合征组,分析再喂养综合征的发生率和影响因素。结果 共130例患者发生再喂养综合征,发生率为30.02%。Logistic回归分析显示,营养风险评估量表2002评分（OR=5.504）、白蛋白浓度（OR=2.295）、前白蛋白浓度（OR=2.957）、是否有糖尿病史（OR=2.536）、喂养途径（OR=2.323）、肠内营养液温度（OR=2.271）、蛋白质摄入情况（OR=3.270）、热量摄入情况（OR=3.965）和喂养速度（OR=2.735）是ICU肠内营养患者发生再喂养综合征的影响因素（P<0.05）。 结论 ICU肠内营养患者再喂养综合征发生率较高,营养风险评估量表2002评分≥3分、低白蛋白浓度、低前白蛋白浓度、有糖尿病史、鼻肠管喂养、36~38 ℃的营养液温度、高蛋白质摄入、高热量摄入和喂养速度过快是发生再喂养综合征的高危因素,建议密切关注ICU肠内营养患者喂养情况,加强喂养护理,控制相关影响因素。

关键词: 危重病, 肠内营养, 再喂养综合征, 影响因素分析, 护理