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经推注法和连续输注法肠内营养对机械通气患者血清磷和血糖水平影响的比较:一项随机临床试验

Comparison of the Effect of Enteral Feeding through the Bolus and Continuous Methods on Serum Phosphorus and Glucose Levels in Patients with Mechanical Ventilation: A Randomized Clinical Trial.

作者信息

Seyyedi Javad, Rooddehghan Zahra, Mohammadi Mostafa, Haghani Shima

机构信息

Department of Medical Surgical Nursing, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran.

School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran.

出版信息

J Nutr Metab. 2020 Sep 8;2020:6428418. doi: 10.1155/2020/6428418. eCollection 2020.

Abstract

INTRODUCTION

Patients who are under mechanical ventilation in intensive care units need to have nutritional support. Also, feeding methods affect serum phosphorus and glucose levels, which are very important in weaning patients off the ventilator. Thus, this study is to compare the effects of both bolus and continuous enteral feeding methods on serum phosphorus and glucose levels in patients with mechanical ventilation.

METHODS

In this clinical trial study, 34 patients in the intensive care unit of Imam Khomeini Hospital affiliated to the Tehran University of Medical Sciences satisfied inclusion criteria and were randomly divided into control and intervention groups. Sampling was done between October and February 2018. The intervention group received continuous enteral feeding for one week, and the control group received nutrition by the bolus method. The blood glucose level was measured every six hours, and the serum phosphorus level was recorded at the beginning and the end of the intervention, based on the data entry form with respect to all ethical considerations. Data analysis was done by SPSS-20 software.

RESULTS

The serum phosphorus level was significantly increased in the intervention group (=0.004) and in the control group ( < 0.001) and was compared with the previous intervention. No significant difference was found between the intervention and control groups before and after the intervention (=0.22) and also one week after the intervention (=0.14). There was also no significant difference between the glucose levels from day 1 to day 7 in the control group (=0.33) and the intervention group (=0.086). . Nutritional support in both bolus and continuous methods increased the serum phosphorus level. It indicates the importance of the nutritional method in controlling the phosphorus level in critically ill patients. However, there was no difference between the effects of dietary methods on blood glucose control.

摘要

引言

重症监护病房中接受机械通气的患者需要营养支持。此外,喂养方式会影响血清磷和葡萄糖水平,这对患者脱机非常重要。因此,本研究旨在比较推注喂养和持续肠内喂养两种方式对机械通气患者血清磷和葡萄糖水平的影响。

方法

在这项临床试验研究中,德黑兰医科大学附属伊玛目霍梅尼医院重症监护病房的34名患者符合纳入标准,被随机分为对照组和干预组。样本采集于2018年10月至2月期间进行。干预组接受一周的持续肠内喂养,对照组采用推注法进行营养支持。每6小时测量一次血糖水平,并根据数据录入表,在考虑所有伦理因素的情况下,于干预开始和结束时记录血清磷水平。数据分析使用SPSS-20软件完成。

结果

干预组(=0.004)和对照组(<0.001)的血清磷水平均较干预前显著升高。干预前后,干预组与对照组之间无显著差异(=0.22),干预一周后也无显著差异(=0.14)。对照组(=0.33)和干预组(=0.086)从第1天到第7天的血糖水平也无显著差异。推注喂养和持续喂养两种营养支持方式均提高了血清磷水平。这表明营养方式对控制重症患者磷水平具有重要意义。然而,不同喂养方式对血糖控制的效果并无差异。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/52dd/7508222/015bd0f12e97/jnme2020-6428418.001.jpg

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