摘要
目的 调查ICU患者肠内营养相关性腹泻的现状，探讨其影响因素，制定肠内营养相关性腹泻预防措施。方法 回顾性调查我院ICU2021年12月-2022年12月肠内营养支持治疗的79例患者临床资料，分析腹泻发生相关危险因素。结果 在79例肠内营养患者中发生腹泻35人，发生率为44.3%。多因素原因分析结果显示肠内营养相关性腹泻与患者禁食时间、用具清洁情况、输注速度、营养液温度、肠内喂养实施标准有密切关系。结论 应结合患者病情尽早实施肠内营养、制定标准化肠内喂养流程、保证营养液温度和选择合适的用具，以预防或降低肠内营养相关性腹泻。
关键词： 肠内营养；腹泻；影响因素；预防；ICU
Abstract
Objective To investigate the status of enteral nutrition-associated diarrhea in ICU patients, explore its influencing factors, and formulate preventive measures for enteral nutrition-associated diarrhea. Methods The clinical data of 79 patients treated with enteral nutrition support in the ICU of our hospital from December 2021 to December 2022 were retrospectively investigated, and the risk factors related to diarrhea were analyzed. Results Diarrhea occurred in 35 of 79 enteral nutrition patients, the incidence rate was 44.3%. The results of multi-factor analysis showed that enteral nutrition-associated diarrhea was closely related to fasting time, equipment cleaning, infusion speed, nutrient solution temperature, and enteral feeding implementation standards. Conclusion Enteral nutrition should be implemented as early as possible in combination with the patient's condition, a standardized enteral feeding process should be established, the temperature of the nutrient solution should be ensured, and appropriate utensils should be selected to prevent or reduce enteral nutrition-related diarrhea.
Key words： Enteral nutrition; Diarrhea; Influencing factors; Prevention; ICU
参考文献 References
[1] 米元元,黄海燕,尚游,等.中国危重症患者肠内营养治疗常见并发症预防管理专家共识（2021版）.中华危重病急救医学,2021,33（8）:903-918
[2] 谢文亮,王淑芳,李旭光,张清.ICU患者肠内营养相关性腹泻风险预测模型的构建及验证.中华护理杂志,2022,19:0254-1769
[3] 张昕悦,王颖,何梅,等.临床护士肠内营养相关性腹泻知信行现状及影响因素析.护理学杂志,2022,（23）:1001-4152
[4] 俞星池,邓杰,杨海波.高蛋白肠内营养对危重患者机械通气时间及营养状况的影响 [J]. 中国中西医结合急救杂志,2020,27（6）:689-692
[5] 昝涛,丛悦,唐晶,等.ICU患者肠内营养执行流程循证实践方案的构建,外文名Construction of evidence-based practice program of enteral feeding implementation process for critically ill patients.中华急危重症护理杂志ISSN:2096-7446,2020,（1）:57-63
[6] Friesechs S, Schwabe A, Stecher SS, et al. Improvement of enteral nutrition in intensive care unit patients by a nurse-driven feeding protocol[J].Nurs Crit Care, 2014, 19(4):204-210.
[7] 中国急诊危重症患者肠内营养治疗专家共识组.中国急诊危重症患者肠内营养治疗专家共识.中华急诊医学杂志ISSN:1671-0282,2022,（3）:281-290
[8] 孙仁华,江荣林,黄曼,等. 重症患者早期肠内营养临床实践专家共识[J]. 中华危重病急救医学,2018,(8):715-721
[9] 蔡悦,王颖,乐霄,等.住院患者肠内营养相关性腹泻的预防及管理最佳证据总结.护理学杂志,2022,（16）:80-84.
[10] 包玫瑰,朱卫萍,胡超,等.肠内营养联合益生菌在危重症患者胃肠功能障碍中的应用效果.中国现代医生,2022,（11）:124-127.