用肠道营养治疗的重症患者的食不耐受:元分析和系统审查
Jing Xu1, Wenyu Shi1, Liying Xie1
1Department of Cardiothoracic surgery, Children's Hospital of Nanjing Medical University, Nanjing, China.
概括
在接受肠道营养的重症患者中,食不耐受是常见的. 关键的危险因素包括年轻/老年,高APACHE II分数,低血,延迟营养开始和机械通风.
科学领域:
- 关键护理医学 关键护理医学
- 临床营养学 临床营养学
- 胃肠病学 胃肠病学
背景情况:
- 食不耐受是临界病患者在肠道营养中经常出现的严重并发症.
- 识别风险因素对于改善临床管理和患者结果至关重要.
研究的目的:
- 在接受肠道营养的重症患者中进行评估食不耐受症的风险因素的元分析.
- 为临床实践提供有关肠道营养治疗和护理的信息.
主要方法:
- 在2023年8月15日之前,对多个数据库进行系统的文献搜索.
- 两个研究人员进行独立的数据提取和质量评估.
- 使用RevMan 5.3和Stata 15.0软件进行的元分析.
主要成果:
- 包括18项研究,涉及5564名患者.
- 确定的危险因素:年轻/年长,APACHE II评分≥20,低血,肠道营养延迟 (>72小时),缺乏食纤维,腹内压力高 (>15mmHg),中央静脉压高 (>10cmH2O) 和机械通风.
- 没有检测到出版偏差.
结论:
- 在接受肠道营养的重症患者中,食不耐受性很普遍,受到许多因素的影响.
- 临床医生应根据已识别的风险和保护因素实施预防策略,以尽量减少发病率并提高患者的预后.
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