摘要
目的:分析临时性回肠造口重症病人早期肠内营养治疗期间腹泻的影响因素。方法:回顾性收集2019年11月至2023年11月东部战区总医院普通外科临时性回肠造口术后接受早期肠内营养治疗的重症病人154例。根据病人是否发生肠内营养相关性腹泻分为腹泻组和非腹泻组,比较两组病人临床资料,进行单因素分析,将有显著差异的指标纳入多因素Logistic回归模型,分析临时性回肠造口重症病人术后早期肠内营养治疗期间腹泻的影响因素。结果:154例病人中共43例在行早期肠内营养治疗期间发生了肠内营养相关性腹泻,发生率为27.9%,经多因素Logistic回归分析显示,肠内营养输注速度(OR=6.342,P=0.001,95%CI:2.055~19.572)、抗生素的使用种类(OR=8.342,P=0.013,95%CI:1.577~44.119)、机械通气(OR=7.011,P=0.001,95%CI:2.272~21.629)、肠内营养制剂类型(OR=6.497,P=0.001,95%CI:2.177~19.392)及糖尿病(OR=3.321,P=0.036,95%CI:1.080~10.215)与临时性回肠造口重症病人术后早期肠内营养相关性腹泻有关。结论:临时性回肠造口重症病人术后早期肠内营养治疗期间腹泻的发生率较高,营养治疗期间应关注肠内营养输注速度、抗生素使用、机械通气、肠内营养制剂类型及糖尿病。
Objective:To investigate the influencing factors of diarrhea during early enteral nutrition(EEN)therapy in severe patients with temporary ileostomy.Method:A total of 154 patients with temporary ileostomy who received EEN in the Department of General Surgery,Jinling Hospital from November 2019 to November 2023 were included in this study.All patients were divided into two groups:the diarrhea group(n=43)and the non-diarrhea group(n=111).The clinical data of the patients were retrospectively collected and analyzed,and univariate analysis was performed to compare the differences between groups.The indicators with significant differences were subjected to multivariate logistic regression analysis to determine the influencing factors of diarrhea during EEN therapy in severe patients with temporary ileostomy.Result:Among the 154 patients,43 developed diarrhea during EEN therapy,with an incidence of 27.9%.Multivariate logistic regression analysis showed that enteral nutrition(EN)infusion rate(OR=6.342,P=0.001,95%CI:2.055~19.572),antibiotics type(OR=8.342,P=0.013,95%CI:1.577~44.119),mechanical ventilation(OR=7.011,P=0.001,95%CI:2.272~21.629),EN formulation type(OR=6.497,P=0.001,95%CI:2.177~19.392),and diabetes(OR=3.321,P=0.036,95%CI:1.080~10.215)were closely associated with EN-related diarrhea in severe patients with temporary ileostomy.Conclusion:There was a high incidence of diarrhea in severe patients with temporary ileostomy who received EEN.EN infusion rate,antibiotics use,mechanical ventilation,EN formulation type and diabetes were the influencing factors for presence of EEN-related diarrhea in the patients.Our data could provide a reference for preventing EEN-related diarrhea in severe patients with temporary ileostomy after surgery.
作者
胡佳佳
顾璐璐
吴翠丽
叶向红
蒋妍
王新颖
HU Jia-jia;GU Lu-u;WU Cui-i;YE Xiang-hong;JIANG Yan;WANG Xin-ying(Research Institute of General Surgery,Jingling Hospital,Nanjing 210002,Jiangsu China;School of Medical Administration,Nanjing Medical University,Nanjing 211166,Jiangsu China)
出处
《肠外与肠内营养》
2025年第1期48-53,共6页
Parenteral & Enteral Nutrition
基金
东部战区总医院院内课题(YYHL2021059,22HLZX17)。
