摘要
目的了解胃癌术后患者早期肠内营养达标状况,分析影响营养达标的因素,为进一步制定有效护理措施改善胃癌术后患者营养支持状况提供参考。方法根据肠内营养制剂第3天供给热量能否达到患者需求[104.6kJ/(kg.d)]的60%,将82例患者分为达标组和未达标组,分析比较两组患者的一般资料及临床特征,通过Logistic回归进行多因素分析,探讨影响早期肠内营养达标的主要因素。结果82例患者中17例(20.73%)达标。达标组患者体质量水平、术中出血量、肠内营养不耐受例数显著低于/少于未达标组(P<0.05,P<0.01)。Logistic回归分析显示,患者体质量、术中失血量、肠内营养不耐受对早期营养达标有影响。结论胃癌术后早期肠内营养实施状况有待进一步提高,体质量越重、术中失血量越多、肠内营养不耐受发生率越高的患者早期肠内营养不达标的危险大。
Objective To investigate to what extent patients′ nutrition levels meet normal requirements,to analyze the influencing factors,and to provide information for nurses to take nutrition-enhancing measures for patients receiving enteral nutrition therapy after gastric cancer surgery. Methods A total of 82 patients receiving enteral nutrition therapy after gastric cancer surgery were divided into a goal-hitting group and a failure group depending on whether calories provided from enteral nutrition reached 60% of total nutrition demand [104.6 kJ/（kg·d）] on the third day.Their demographic information and clinical characteristics were compared.Logistic regression was performed to identify main factors boosting normal nutrition in patients receiving enteral nutrition therapy.Results Of 82 cases,17（20.73%） cases′ nutrition levels meet normal requirements.Body weight,blood loss,gastrointestinal intolerance in the goal-hitting group were significantly lower/smaller than those in the failure group（P0.05,P0.01）.The results of logistic regression analysis showed that patients′ body weight,intraoperative blood loss,gastrointestinal intolerance contributed to jeopardize patients′ nutrition levels which failed to meet early goal of enteral nutrition therapy. Conclusion The implement of enteral nutrition therapy should be improved.Those with heavier weight,more blood loss,or gastrointestinal intolerance are likely to fail to hit their early nutrition goal.
基金
南京医科大学第一附属医院护理重点专科项目(2011058)
关键词
胃癌
胃癌根治术
肠内营养
营养达标
影响因素
gastric carcinoma
radical surgery for gastric carcinoma
enteral nutrition
nutrition levels up to goal
influencing factors
