腹部开放和负压治疗患者的肠道食:倾向性评分分析
Laurent Petit1, Nicolas Faure1, Bruno Pereira2
1Anesthesiology and Critical Care Department, Pellegrin University Hospital, Bordeaux, France.
Journal of abdominal wall surgery : JAWS
|January 2, 2025
概括
在重症外科患者的早期肠道营养,开放腹部和负压治疗 (OA/NPT) 改善了临床结果,减少了并发症. 这支持及时的营养干预,以改善OA/NPT患者的康复.
科学领域:
- 手术重症监护手术重症监护
- 胃肠病学 胃肠病学
- 营养科学 营养科学
背景情况:
- 营养支持在接受开腹和负压疗法 (OA/NPT) 的重症手术患者中的作用仍在争论中.
- 在这种患者群体中优化临床结果需要了解早期营养干预措施的影响.
研究的目的:
- 评估OA/NPT前7天内肠道营养支持对临床结果的影响.
- 评估早期肠道营养与腹壁关闭率或囊形成之间的关联.
主要方法:
- 在5年内对171名急症手术患者进行了OA/NPT治疗的回顾性分析.
- 使用治疗重量的逆概率 (IPTW) 和多变量逻辑回归.
- 基于肠道营养与无人营养,营养时间和热量/蛋白质摄入量的比较结果.
主要成果:
- 50%的患者经历了延迟腹部关闭或二次腹部并发症.
- 7天内肠道营养与这些并发症的发生率显著降低 (40%与61%相比,p=0.007).
- 对肠道营养不良结果的IPTW调整的几率比为0.49 (95%CI:0.25-0.98).
结论:
- 在OA/NPT重症患者中,早期肠道养 (7天内) 与改善临床结果有关.
- 需要进一步的研究来确定最佳时间,热量和蛋白质要求,以在OA/NPT后的急性阶段提供营养支持.
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