论文部分内容阅读
目的:通过对脓毒症病人肠内营养(EN)耐受性影响因素的分析,探讨影响EN吸收的相关因素。方法:选取脓毒症病人85例,所选择的病人均符合脓毒症诊断标准,存在感染或高度怀疑存在感染同时,符合全身性炎症反应综合征(SIRS)≥2项标准者,通过可能影响脓毒症病人EN耐受的因素分析,观察不同影响因素对脓毒症EN病人24至72 h内胃肠道的反应,探讨影响脓毒症病人EN耐受性的因素。结果:当病人使用镇静药和抑酸药、机械通气、低蛋白血症(血清清蛋白<35 g/L)、粪肠球/杆菌比例≥2∶8、APARCHⅡ评分≥15分和营养液渗透浓度≥330 mmol/L时,胃肠道各种不良反应的发生率明显增高,置入空肠营养管后不良反应的发生率明显减少。结论:镇静药、抑酸药、机械通气、血清清蛋白水平、粪肠球/杆菌比例、EN途径、APARCHⅡ评分、营养液渗透浓度等对脓毒症病人EN的耐受性有不同程度影响。
OBJECTIVE: To investigate the influencing factors of enteral nutrition (EN) tolerance in sepsis patients and to explore the relevant factors affecting EN absorption. Methods: Totally 85 sepsis patients were selected. All the patients were selected to meet the diagnostic criteria of sepsis. Infected or highly suspected of infection were present. Patients with systemic inflammatory response syndrome (SIRS) To analyze the factors of EN tolerance in sepsis patients and observe the response of different influencing factors to the gastrointestinal tract within 24 to 72 h in septic patients with EN and to explore the factors influencing the EN tolerance in septic patients. Results: When patients were treated with sedatives and antacids, mechanical ventilation, hypoalbuminemia (serum albumin <35 g / L), faecal ball / bacilli ratio ≥2: 8, APARCHⅡ score ≥15 and infiltration of nutrient solution The concentration of ≥330 mmol / L, the incidence of various gastrointestinal adverse reactions was significantly increased, the placement of jejunal feeding tube adverse reactions after the incidence was significantly reduced. CONCLUSIONS: The sedatives, antacids, mechanical ventilation, serum albumin levels, fecal enterococci / bacilli ratio, EN pathway, APARCHⅡscore and infiltration of nutrient solution have different effects on EN tolerance in sepsis patients.