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对某大学医院重症监护病房接受全胃肠外营养治疗患者的数据回顾。

Review of data of the patients receiving total parenteral nutrition at the intensive care unit of a university hospital.

作者信息

Ovayolu Nimet, Torun Seda, Ucan Ozlem, Ozdemir Perihan, Buyukhatipoglu Hakan, Pehlivan Yavuz, Geyik Ramazan

机构信息

Gaziantep University Health Sciences School, Turkey.

出版信息

J Natl Med Assoc. 2006 Dec;98(12):1958-62.

Abstract

Parenteral nutrition is commonly administered to patients in intensive care units who cannot be fed gastrointestinally. Several problems might be encountered during parenteral nutrition. We designed this study to evaluate two years' data of the patients who received parenteral nutrition at the intensive care unit of the university hospital. Forty-five patients who were treated at this hospital between January 1, 2004 and December 31, 2005 were included in this study. Patient data were collected via questionnaires designed based on the information in the literature. Blood, urinary, oropharyngeal and catheter entry site cultures were obtained and analyzed on the third and seventh days of the treatment. We found the following results: 31.1% of the patients received parenteral nutrition due to renal insufficiency; ready-made amino acid/lipid solutions were used in 86.7% of the patients; 77.8% of the solutions were administered through a peripheral vein; 88.6% of total parenteral nutrition solutions given thorough the peripheral vein had higher osmolarities than 800 mOsmol/L; routine Fe and Fe binding capacity, prothrombin time, cholesterol and triglyceride level assessments were not performed before the initiation of treatment; and the culture tests most commonly revealed Staphylococcus epidermidis in the blood, Candido species in urine, Streptococcus in throat, and Staphylococcus aureus at catheter entry sites. Based on these results, we suggest that organizing a nutrition support team would be useful in order to improve the quality of the nursery and to provide close and rational management and follow-up of the patients receiving total parenteral nutrition.

摘要

肠外营养通常用于重症监护病房中无法通过胃肠道进食的患者。肠外营养过程中可能会遇到一些问题。我们设计了这项研究,以评估在大学医院重症监护病房接受肠外营养患者的两年数据。本研究纳入了2004年1月1日至2005年12月31日期间在该医院接受治疗的45名患者。通过根据文献信息设计的问卷收集患者数据。在治疗的第三天和第七天采集血液、尿液、口咽和导管入口处培养物并进行分析。我们发现以下结果:31.1%的患者因肾功能不全接受肠外营养;86.7%的患者使用了预制氨基酸/脂质溶液;77.8%的溶液通过外周静脉给药;通过外周静脉给予的全肠外营养溶液中88.6%的渗透压高于800 mOsmol/L;在开始治疗前未进行常规铁和铁结合能力、凝血酶原时间、胆固醇和甘油三酯水平评估;培养测试最常显示血液中为表皮葡萄球菌、尿液中为念珠菌属、咽喉中为链球菌、导管入口处为金黄色葡萄球菌。基于这些结果,我们建议组建一个营养支持团队,以提高护理质量,并对接受全肠外营养的患者进行密切合理的管理和随访。

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