摘要
目的:分析南通大学附属医院神经外科重症监护病房(neurosurgery intensive care unit,NICU)收治患者的营养治疗现状。方法:以2022年1月—2023年1月入住南通大学附属医院NICU的患者为调查对象,收集患者基本信息和临床指标,包括营养风险筛查评分(nutrition risk score 2002,NRS 2002)、危重症营养风险评分(nutrition risk score in the critically ill,NUTRIC)、胃肠功能损伤分级、营养治疗实施的时机和途径、入病房第1、3和7天热卡及蛋白达标情况、喂养耐受情况以及患者的28 d临床转归情况。结果:调查共收集患者133例,平均年龄(58.3±15.4)岁。患者格拉斯哥昏迷评分、序贯器官衰竭评分和急性生理与慢性健康评分分别为(4.07±2.41)、(7.10±2.59)、(11.0±3.4)分。28 d临床转归存活100例(75.2%),死亡33例(14.8%)。除BMI(P=0.0192)外,男性与女性患者在年龄、病情严重程度方面差异均无统计学意义(均P>0.05)。133例患者中,胃肠功能正常或轻度损害95例(71.4%),中-重度损害29例(21.8%),衰竭8例(6.0%)。入NICU 24 h内即开始肠内营养(enteral nutrition,EN)患者82例(61.7%)。72 h内达到20 kcal/(kg·d)的热卡目标的有28例(31.5%),1周总热卡达标率为12.3%(11/89),达到80%蛋白质喂养目标的有5例(3.76%)。高营养风险组的白蛋白水平在入NICU第7天显著低于低营养风险组。结论:目前我院NICU内超过70%的患者在48 h内接受EN治疗,喂养期间出现最多的不耐受症状是腹胀。补充性肠外营养的比例、1周左右的热卡及蛋白达标率均较低。应加强个性化制定热卡和蛋白目标进行营养补充。
Objective:To analyze the nutritional treatment status of patients in neurosurgery intensive care unit(NICU)of the Affiliated Hospital of Nantong University.Methods:The patients were investigated when admitted to the NICU from January 2022 to January 2023.Demographic and clinical parameters of those patients were recorded including nutrition risk score 2002(NRS 2002),nutrition risk score in the critically ill(NUTRIC),gastrointestinal function injury classification,timing and path of nutrition implementation,energy and protein compliance on the 1,3 and 7 day of admission,feeding tolerance and clinical outcome on 28 days after the investigation.Results:The average age of 133 cases was(58.3±15.4)years old.The Glasgow coma scale,sequential organ failure assessment and acute physiology and chronic health evaluationⅡwere(4.07±2.41),(7.1±2.59)and(11.0±3.4)scores,respectively.The outcomes of 28 days after the investigation day were 100 cases(75.2%)survived,33 cases(14.8%)non-survivors.There was no significant difference in age and severity of diseasse between male and female patients except BMI(P=0.0192).95(71.4%)in gastrointestinal function,patients had normal or mild damage,29(21.8%)had moderate to severe damage,and 8(6.0%)had gastrointestinal failure.82(61.7%)patients who started enteral nutrition(EN)within 24 h in the NICU.In 72 h,28(31.5%)patients reached the target of 20 kcal/(kg·d)energy target and 11(12.3%)cases reached estimated energy target at 7 d,and 5(3.76%)cases reached the target of 80%protein feeding.The level of albumin after NICU admission for 7 day was significantly higher in patients with higher NUTRIC score.Conclusions:At present,more than 70%of patients in NICU of our hospital can receive EN treatment within 48 h,and the most intolerant symptom during feeding is abdominal distension.The proportion of supplementary parenteral nutrition and energy and protein target reaching rate in about one week were low.It is necessary to design an individualized and gradually plan of energy and protein targets in the future.
作者
顾融融
范小飞
殷晓芹
沈剑虹
GU Rongrong;FAN Xiaofei;YIN Xiaoqin;SHEN Jianhong(Department of Pharmacy,Affiliated Hospital of Nantong University,Jiangsu 226001;Department of Neurosurgery,Affiliated Hospital of Nantong University,Jiangsu 226001)
出处
《南通大学学报（医学版）》
2024年第5期419-422,共4页
Journal of Nantong University(Medical sciences)
基金
江苏省新药研究与临床药学重点实验室开放研究课题(KF-XY201901)
江苏省药学会—奥赛康医院药学基金项目(A202128)。
关键词
神经外科重症监护病房
营养治疗
蛋白质
能量
胃肠功能障碍
neurosurgical intensive care unit
nutritional treatment
protein
energy
acute gastrointestinal injure
