上海交通大学学报（医学版）

上海交通大学学报（医学版）

• 短篇论著 • 上一篇    下一篇

住院患者肠外营养支持时间的相关因素回顾性研究

徐仁应1，万燕萍1，高键2，周一泉1，陈之琦1，张晓敏1，陆丽萍1   

  1. 1.上海交通大学 医学院附属仁济医院临床营养科， 上海 200127； 2.复旦大学附属中山医院营养科， 上海 200032
  • 出版日期:2015-09-28 发布日期:2015-09-30
  • 通讯作者: 万燕萍, 电子信箱: wanyp204@163.com。
  • 作者简介:徐仁应（1974—）， 男， 副主任医师， 博士; 电子信箱: xurenying7465@126.com。
  • 基金资助:

    上海交通大学医学院附属仁济医院种子基金 （ZJZZ13-019）

Analysis of influencing factors on duration of parenteral nutrition in hospitalized patients

XU Ren-ying1, WAN Yan-ping1, GAO Jian2, ZHOU Yi-quan1, CHEN Zhi-qi1, ZHANG Xiao-min1, LU Li-ping1   

  1. 1.Department of Clinical Nutrition, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China; 2.Department of Nutrition, Zhongshan Hospital, Fudan University, Shanghai 200032, China
  • Online:2015-09-28 Published:2015-09-30
  • Supported by:

    Seed Fund of Renjin Hospital of Shanghai Jiao Tong University School of Medicine, ZJZZ13-019

PDF (PC)

927

摘要：

目的  分析住院患者接受肠外营养（PN）支持时间的影响因素。方法  收集接受PN治疗(≥3 d)住院患者的临床资料。记录患者一般情况（年龄、性别、身高、体质量、入院诊断及是否有手术、机械通气和慢性病病史）、血生化指标（PN前血常规、血糖、血脂、肝肾功能、血钙、血磷、血镁指标）和PN相关指标（PN时间、PN输注时微循环血糖、日均蛋白质和能量供给量）。 目标供给量依据Schofield公式计算。结果  共收集643例接受PN治疗住院患者的临床资料，其中男性423例，女性220例。接受PN时间的中位数为8 d（3~370 d），其中全禁食者占72.8%。多因素方差分析结果显示：心血管疾病史、机械通气、血γ谷氨酰转肽酶（γ-GT）水平和PN期间日均能量供给（<75%目标剂量）是PN支持时间的影响因素。结论  具有心血管疾病病史、使用机械通气、血γ-GT升高和PN日均能量供给较低使PN支持时间延长。

关键词: 肠外营养, 日均能量供给, 日均蛋白质供给

Abstract:

Objective  To analyze influencing factors on duration of parenteral nutrition (PN) in hospitalized patients. Methods  The clinical data of hospitalized patients who received PN for more than 3 d were collected. General information (age, gender, height, body weight, diagnosis, surgery, mechanical ventilation, and chronic metabolic diseases), blood biochemical indexes (blood routine, fast blood sugar, liver function, kidney function, calcium, phosphorus, magnesium before PN), and PN related indexes (duration, blood sugar when infusion of PN, daily calorie and protein supplementation) were recorded and the calorie goal was calculated by Schofield equation. Results  The clinical data of 643 hospitalized patients who received PN were collected. Among them, 423 were males and 220 were females. The median duration of PN was 8 d (3-370 d) and 72.8% of patients underwent total fasting. The results of multivariate variance analysis showed that history of cardiovascular diseases, mechanical ventilation, blood gamma glutamyl transpeptidase level, and average daily calorie supplement (<75% energy goal) were influencing factors of PN duration. Conclusion  Cardiovascular diseases, mechanical ventilation, high gamma glutamyl transpeptidase level, and low average daily calorie supplement can lengthen the PN duration.

Key words: parenteral nutrition, daily calorie supplement, daily protein supplement