肠内营养耐受性评估表在重症患者肠内营养中的应用
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摘要
目的:探究在重症患者肠内营养中使用肠内营养耐受性评估表后的效果。方法:选取本院2017年4月-2018年4月收治的重症监护室(ICU)、神经内科重症病房、急诊重症监护室(EICU)、心脏病重症监护室(CCU)的患者100例作为研究对象,按照随机数字表法将其分成护理1组与护理2组,各50例。护理1组在常规护理的基础上应用肠内营养耐受性评估表配合集束化护理模式展开护理,护理2组采用常规护理,观察比较两组护理后肠内营养达标、中断营养输注及并发症发生情况、护理前后的体格指标水平以及患者家属护理满意度。结果:护理后,护理1组肠内营养达标率为98.0%明显高于护理2组的84.0%,中断营养输注及并发症的发生率分别为2.0%、2.0%,均明显低于护理2组的14.0%、16.0%,差异均有统计学意义(P<0.05)。护理后,护理1组体重指数(BMI)、臂肌围(MAMC)指标水平均明显高于护理2组,差异均有统计学意义(t=3.629、2.327,P=0.000、0.022)。护理1组患者家属护理满意度为98.0%,明显高于护理2组的84.0%,差异有统计学意义(字2=5.983,P=0.014)。结论:将肠内营养耐受性评估表应用于使用肠内营养的重症患者时,能准确判断出患者是否出现不耐受情况,能及时调整输注剂量,减少并发症的发生,此方法值得应用与推广。
Objective:To explore the effect of enteral nutrition tolerance assessment form in enteral nutrition of severe patients.Method:A total of 100 patients admitted in the intensive care unit(ICU),neurology intensive care unit,emergency intensive care unit(EICU) and cardiology intensive care unit(CCU) of our hospital from April 2017 to April 2018 were selected as the research objects.According to the random number table method,they were divided into nursing group 1 and nursing group 2,50 cases in each group.Nursing group 1 was treated with enteral nutrition tolerance assessment form combined with cluster nursing mode on the basis of routine nursing,nursing group 2 was treated with routine nursing.The enteral nutrition standards,interruption of nutrition infusion and complications after nursing,physical indicators before and after nursing and nursing satisfaction of patients' families between the two groups were observed and compared.Result:After nursing, the standard rate of enteral nutrition in nursing group 1 was 98.0%,which was significantly higher than 84.0% in nursing group 2;the incidence of interruption of nutritional infusion and complications were 2.0% and 2.0%, respectively,which were significantly lower than 14.0% and 16.0% in nursing group 2,the differences were statistically significant(P<0.05). After nursing,body mass index(BMI) and mid-arm muscle circumference(MAMC) of nursing group 1 were significantly higher than those of nursing group 2,the differences were statistically significant(t=3.629,2.327;P=0.000,0.022).The satisfaction degree of patients' families in nursing group 1 was 98.0%,which was significantly higher than 84.0% in nursing group 2,the difference was statistically significant( 字2=5.983,P=0.014).Conclusion:The enteral nutrition tolerance assessment form is applied to enteral nutrition of severe patients,it can accurately judge whether the patients have intolerance conditions,adjust their infusion dosage in time and reduce the incidence of complications,it is worthy of clinical application and promotion.
Objective:To explore the effect of enteral nutrition tolerance assessment form in enteral nutrition of severe patients.Method:A total of 100 patients admitted in the intensive care unit(ICU),neurology intensive care unit,emergency intensive care unit(EICU) and cardiology intensive care unit(CCU) of our hospital from April 2017 to April 2018 were selected as the research objects.According to the random number table method,they were divided into nursing group 1 and nursing group 2,50 cases in each group.Nursing group 1 was treated with enteral nutrition tolerance assessment form combined with cluster nursing mode on the basis of routine nursing,nursing group 2 was treated with routine nursing.The enteral nutrition standards,interruption of nutrition infusion and complications after nursing,physical indicators before and after nursing and nursing satisfaction of patients' families between the two groups were observed and compared.Result:After nursing, the standard rate of enteral nutrition in nursing group 1 was 98.0%,which was significantly higher than 84.0% in nursing group 2;the incidence of interruption of nutritional infusion and complications were 2.0% and 2.0%, respectively,which were significantly lower than 14.0% and 16.0% in nursing group 2,the differences were statistically significant(P<0.05). After nursing,body mass index(BMI) and mid-arm muscle circumference(MAMC) of nursing group 1 were significantly higher than those of nursing group 2,the differences were statistically significant(t=3.629,2.327;P=0.000,0.022).The satisfaction degree of patients' families in nursing group 1 was 98.0%,which was significantly higher than 84.0% in nursing group 2,the difference was statistically significant( 字2=5.983,P=0.014).Conclusion:The enteral nutrition tolerance assessment form is applied to enteral nutrition of severe patients,it can accurately judge whether the patients have intolerance conditions,adjust their infusion dosage in time and reduce the incidence of complications,it is worthy of clinical application and promotion.
引文
[1]邢丽娟.重症患者肠内营养胃肠道不耐受现象防治研究进展[J].现代中西医结合杂志,2014,23(36):4102-4104.
[2]黄丽燕.重症患者肠内营养常见并发症的原因分析及护理对策[J].广西医学,2014,36(12):1838-1840.
[3]许磊,王婷,陈亭,等.重症患者肠内营养喂养不耐受临床常用措施效果分析[J].第三军医大学学报,2017,39(11):1171-1176.
[4]郭敏,黄妮娜,陈燕河,等.重症患者肠内营养改良的效果观察[J].护理学报,2015,22(5):55-58.
[5]王俊莉,付显芬,盛孝敏,等.重症患者肠内营养的集束化护理[J].检验医学与临床,2017,14(9):1324-1326.
[6]朱丽,高纯,冯永东,等.肠内营养耐受性评估表对胃癌术后患者早期肠内营养耐受性的影响[J].现代临床护理,2015,14(7):18-22.
[7]曹岚,叶向红,张丽娜,等.重症患者阶梯式早期下床活动与肠内营养耐受性相关性研究[J].中国实用护理杂志,2018,34(9):648-651.
[8]朱力,绳宇.持续与间断肠内营养喂养方式对危重患者肠内营养耐受性的影响分析[J].中华现代护理杂志,2017,23(8):1113-1116.
[9]周飞燕,许勤,陈丽,等.胃癌病人术后早期肠内营养喂养不足及其原因的调查分析[J].肠外与肠内营养,2012,19(1):62-64.
[10]叶向红,彭南海,江方正,等.重症急性胰腺炎合并腹腔高压患者早期肠内营养耐受性的管理[J].中华护理杂志,2016,51(12):1439-1442.
[11]于娣,龙玲,赵鹤龄,等.血流动力学不稳定重症患者肠内营养的耐受性与安全性[J].中华急诊医学杂志,2016,25(1):113-116.
[12]叶向红,张君芳,刘炜,等.1例十二指肠瘘患者早期肠内营养耐受性的评估及管理[J].中华护理杂志,2016,51(9):1148-1150.
[13]严正,黄英姿,吕国忠,等.严重烧伤患者肠内营养不耐受的影响因素及与预后的相关性[J].广东医学,2016,37(4):567-569.
[14]查建华,顾新华,袁政,等.胃癌术后早期肠内营养的应用及耐受性研究[J].中国血液流变学杂志,2015,25(2):189-190,240.
[15]韩超,赵艺媛,陶立燕,等.食管癌患者术后早期肠内营养支持耐受性及影响因素的研究[J].中国中西医结合急救杂志,2015,22(3):304-306.
[2]黄丽燕.重症患者肠内营养常见并发症的原因分析及护理对策[J].广西医学,2014,36(12):1838-1840.
[3]许磊,王婷,陈亭,等.重症患者肠内营养喂养不耐受临床常用措施效果分析[J].第三军医大学学报,2017,39(11):1171-1176.
[4]郭敏,黄妮娜,陈燕河,等.重症患者肠内营养改良的效果观察[J].护理学报,2015,22(5):55-58.
[5]王俊莉,付显芬,盛孝敏,等.重症患者肠内营养的集束化护理[J].检验医学与临床,2017,14(9):1324-1326.
[6]朱丽,高纯,冯永东,等.肠内营养耐受性评估表对胃癌术后患者早期肠内营养耐受性的影响[J].现代临床护理,2015,14(7):18-22.
[7]曹岚,叶向红,张丽娜,等.重症患者阶梯式早期下床活动与肠内营养耐受性相关性研究[J].中国实用护理杂志,2018,34(9):648-651.
[8]朱力,绳宇.持续与间断肠内营养喂养方式对危重患者肠内营养耐受性的影响分析[J].中华现代护理杂志,2017,23(8):1113-1116.
[9]周飞燕,许勤,陈丽,等.胃癌病人术后早期肠内营养喂养不足及其原因的调查分析[J].肠外与肠内营养,2012,19(1):62-64.
[10]叶向红,彭南海,江方正,等.重症急性胰腺炎合并腹腔高压患者早期肠内营养耐受性的管理[J].中华护理杂志,2016,51(12):1439-1442.
[11]于娣,龙玲,赵鹤龄,等.血流动力学不稳定重症患者肠内营养的耐受性与安全性[J].中华急诊医学杂志,2016,25(1):113-116.
[12]叶向红,张君芳,刘炜,等.1例十二指肠瘘患者早期肠内营养耐受性的评估及管理[J].中华护理杂志,2016,51(9):1148-1150.
[13]严正,黄英姿,吕国忠,等.严重烧伤患者肠内营养不耐受的影响因素及与预后的相关性[J].广东医学,2016,37(4):567-569.
[14]查建华,顾新华,袁政,等.胃癌术后早期肠内营养的应用及耐受性研究[J].中国血液流变学杂志,2015,25(2):189-190,240.
[15]韩超,赵艺媛,陶立燕,等.食管癌患者术后早期肠内营养支持耐受性及影响因素的研究[J].中国中西医结合急救杂志,2015,22(3):304-306.