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目的观察重型颅脑损伤患者的营养支持情况,分析营养支持与预后的关系。方法选择ICU中56例重型颅脑损伤患者,记录每日摄入热量,计算能量平衡;用Logistic回归分析营养支持影响预后的情况。结果全部患者实际摄入能量平均为(5966±1973)kJ/d,能量负平衡平均为(822±314)kJ/d。前3天能量负平衡最严重,实际摄入能量值明显低于目标能量值[(3258±1280)kJ比(5977±976)kJ,P<0.01],随时间延长,实际摄入能量值逐渐上升,前14天是发生能量负平衡的主要时期。Logistic回归分析显示,营养负平衡与并发症相关[感染的优势化(OR值)2.129,95%可信区间(95%CI)为(1.528,29.886),P=0.023;上消化道出血的OR值0.091,95%CI(0.013,0.545),P=0.009]。结论营养负平衡与重型颅脑损伤患者的并发症相关;及早补充足够的能量,可能改善患者的预后。
Objective To observe the nutritional support of patients with severe craniocerebral injury and to analyze the relationship between nutritional support and prognosis. Methods Fifty-six patients with severe craniocerebral injury in the ICU were enrolled. Daily intake of calories was recorded and energy balance was calculated. Logistic regression was used to analyze the prognosis of nutritional support. Results The average actual energy intake of all patients was (5966 ± 1973) kJ / d, and the average negative energy balance was (822 ± 314) kJ / d. The energy balance was the most serious in the first 3 days, and the actual energy intake value was significantly lower than the target energy value [(3258 ± 1280) kJ (5977 ± 976) kJ, P <0.01]. With the prolongation of time, Rise, the first 14 days is the main period of negative energy balance. Logistic regression analysis showed that nutritional balance was associated with complications (odds ratio 2.129, 95% CI (1.528, 29.886), P = 0.023; odds of upper gastrointestinal bleeding 0.091, 95% CI (0.013, 0.545), P = 0.009]. Conclusion Negative nutrition balance is associated with the complication of patients with severe craniocerebral injury. The early replenishment of sufficient energy may improve the prognosis of patients.