Abstract:

Objective To construct and apply an enteral nutrition protocol for patients with intra-abdominal hypertension oriented by intra-abdominal pressure，and provide systematic and standardized interventions for the implementation of enteral nutrition for patients with intra-abdominal hypertension，to reduce the incidence of feeding intolerance and improve the feeding compliance rate. Methods Through literature review and the Delphi method，the enteral nutrition protocol for patients with intra-abdominal hypertension was constructed，and 218 patients with intra-abdominal hypertension admitted to the emergency ICU of a tertiary hospital in Zhejiang Province from January to October 2022 were selected by convenient sampling method. The experimental group used the enteral nutrition protocol for patients with intra-abdominal hypertension oriented by intra-abdominal pressure for enteral nutrition treatment，and the control group used the conventional enteral nutrition treatment in ICU. The incidence of feeding intolerance symptoms，the feeding compliance rate on the 3rd and 7th day of enteral nutrition，the duration of enteral nutrition，and the number of days in ICU were compared between the 2 groups. Results The incidence of feeding intolerance symptoms in the experimental group（58.70%） was lower than that in the control group（74.31%）；the feeding compliance rate on the 3rd day of enteral nutrition（31.19%） was higher than that in the control group （16.51%）；the rate of feeding on the 7th day of enteral nutrition（28.44%） was higher than that in the control group（13.76%），and the differences were statistically significant（all P<0.05）. There was no significant difference in the duration of enteral nutrition and ICU stay between the 2 groups（all P>0.05）. Conclusion The enteral nutrition protocol for patients with intra-abdominal hypertension oriented by intra-abdominal pressure has clinical guiding significance，which can reduce the incidence of feeding intolerance and improve the feeding compliance rate in patients with intra-abdominal hypertension.

Key words: Intensive Care, Intra-Abdominal Pressure, Enteral Nutrition, Feeding Intolerance, Nursing Care

摘要：

目的 构建并应用以腹内压监测为导向的腹腔高压患者肠内营养护理方案，为腹腔高压患者实施肠内营养提供系统、规范的干预措施，以降低患者喂养不耐受发生率，提高喂养达标率。 方法 通过查阅文献和德尔菲专家函询，构建以腹内压监测为导向的腹腔高压患者肠内营养护理方案，采用方便抽样法，2022年1月—10月选择218例入住浙江省某三级甲等医院急诊ICU的腹腔高压患者作为应用对象，试验组采用以腹内压监测为导向的腹腔高压患者肠内营养护理方案进行肠内营养治疗，对照组采用ICU常规肠内营养治疗。比较两组喂养不耐受症状发生率，肠内营养第3、7天的目标热量达标率，肠内营养持续天数，ICU入住天数。 结果 试验组喂养不耐受症状发生率为58.70%，低于对照组的74.31%；试验组肠内营养第3天目标热量达标率为31.19%，高于对照组的16.51%；试验组肠内营养第7天目标热量达标率为28.44%，高于对照组的13.76%，两组比较，差异均具有统计学意义（均P<0.05）。两组肠内营养持续天数、ICU入住天数比较，差异均无统计学意义（均P>0.05）。 结论 以腹内压监测为导向的腹腔高压患者肠内营养护理方案具有临床指导意义，可降低腹腔高压患者喂养不耐受症状发生率，提高喂养达标率。

关键词: 重症监护, 腹内压, 肠内营养, 喂养不耐受, 护理