摘要
目的通过Meta分析明确ICU肠内营养腹泻的影响因素,为临床上预防腹泻的产生提供一定的理论依据。方法利用计算机检索多个中英文数据库,获得已公开发表的有关ICU肠内营养腹泻影响因素的病例对照研究。筛选出符合纳入、排除标准文献,并进行文献质量评价。采用RevMan 5.2进行数据分析。结果11篇文献累计实验对象1 615例,其中腹泻组630例、非腹泻组985例,经Meta分析,具有统计学意义的ICU肠内营养腹泻的影响因素,低蛋白血症:OR=2.53,95%CI为(1.98,3.25),P<0.01;肠内营养开始时间:OR=0.42,95%CI为(0.20,0.87),P=0.02;肠内营养逐渐增量:OR=0.37,95%CI为(0.23,0.59),P<0.01;肠内营养前禁食:OR=4.36,95%CI为(1.41,13.53),P=0.01;肠内营养输注速度:OR=0.22,95%CI为(0.11,0.46),P<0.01;肠内营养总量:OR=0.23,95%CI为(0.14,0.40),P<0.01;大量使用抗生素:OR=4.83,95%CI为(3.44,6.78),P<0.01;抗生素使用时间:OR=6.07,95%CI为(2.97,9.17),P=0.0001;口服钾制剂:OR=3.53,95%CI为(2.17,5.75),P<0.01;肠道菌群药物:OR=0.52,95%CI为(0.32,0.83),P=0.006;ICU住院时间:OR=6.27,95%CI为(4.32,8.22),P<0.01。结论低蛋白血症、肠内营养开始时间、肠内营养逐渐增量、肠内营养前禁食、肠内营养输注速度、肠内营养输注总量、大量使用抗生素、抗生素使用时间、口服钾制剂、肠道菌群药物及ICU住院时间是ICU肠内营养腹泻的影响因素。
Objective To understand the influencing factors of enteral nutrition-associated diarrhea in ICU by Meta analysis to provide references for clinical diarrhea prevention.Method Search for published case-control study on influencing factors of enteral nutrition-associated diarrhea in ICU on several Chinese and English database.Find out literature accorded with the inclusive or excluded criteria and evaluate its quality.Analyze the data by RevMan 5.2.Result There are 1615 cases in 11 piece of literature,for 630 cases in diarrhea group and 985 cases in non-diarrhea group.Meta analysis shows significant influencing factors of diarrhea during enteral nutrition support in ICU as below.Hypoproteinemia:OR=2.53,95%CI=(1.98,3.25),P<0.01.Start time of enteral nutrition:OR=0.42,95%CI=(0.20,0.87),P=0.02.Increasing of enteral nutrition:OR=0.37,95%CI=(0.23,0.59),P<0.01.Fast before enteral nutrition:OR=4.36,95%CI=(1.41,13.53),P=0.01.Infusion speed:OR=0.22,95%CI=(0.11,0.46),P<0.01.Infusion amount:OR=0.23,95%CI=(0.14,0.40),P<0.01.Large amount of antibiotics:OR=4.83,95%CI=(3.44,6.78),P<0.01.Time of using antibiotics:OR=6.07,95%CI=(2.97,9.17),P=0.0001.Oral potassium preparation:OR=3.53,95%CI=(2.17,5.75),P<0.01.Medicine on intestinal flora:OR=0.52,95%CI=(0.32,0.83),P=0.006.Days in ICU:OR=6.27,95%CI=(4.32,8.22),P<0.01.Conclusion Hypoproteinemia,start time of enteral nutrition,increasing of enteral nutrition,fast before enteral nutrition,infusion speed,intusion amount,large amount of antibiotics,time of using antibiotics,oral potassium preparation,medicine on intestinal flora and days in ICU are influencing factors of diarrhea during enteral nutrition support in ICU.
作者
蒲秋霞
沈丽娟
包戈华
宏亚丽
Pu Qiuxia;Shen Lijuan;Bao Gehua;Hong Yali(Qibo Medical School of Longdong University,Qingyang Gansu 745000,China;The First People’s Hospital of Huzhou,Huzhou Zhejiang 313000,China)
出处
《护理与康复》
2018年第4期6-14,共9页
Journal of Nursing and Rehabilitation
