摘要
目的探讨危重症患者营养支持后发生再喂养综合征(RFS)的影响因素。方法选择入住ICU的危重症患者141例,观察其营养支持后RFS发生情况,并收集相关资料,包括一般特征、基础情况、实验室检查结果、病情严重程度评分系统、营养相关指标。用单因素分析及多因素Logistic回归分析危重症患者营养支持后发生RFS的影响因素。结果141例危重症患者,营养支持后发生RFS 66例、未发生RFS(非RFS)75例。单因素分析结果显示,RFS患者与非RFS患者年龄、性别、肿瘤病史、合并感染及入院时白蛋白、血磷、水平、急性生理与慢性健康评分系统Ⅱ评分、危重症营养风险(NUTRIC)评分比较差异有统计学意义(P均<0.05)。多因素Logistic回归分析结果显示,男性(OR=3.37,95%CI:1.19~9.59)、合并感染(OR=3.87,95%CI:1.22~12.33)、有肿瘤病史(OR=5.70,95%CI:1.33~24.54)及入院时低白蛋白(OR=0.89,95%CI:0.84~0.95)、低血磷(OR=0.10,95%CI:0.01~0.67)、高NUTRIC评分(OR=2.27,95%CI:1.50~3.42)为危重症患者营养支持后发生RFS的独立危险因素(P均<0.05)。结论性别、感染、肿瘤病史及入院时白蛋白、血磷、NUTRIC评分是危重症患者营养支持后发生RFS的影响因素。
Objective To investigate the risk factors for refeeding syndrome(RFS)in critically ill patients following nutritional support.Methods A total of 141 critically ill patients admitted to the ICU were selected,and we observed the occurrence of RFS after nutritional support.We collected the relevant data on RFS,including general characteristics,basic conditions,laboratory test results,disease severity scoring system,and nutrition-related indicators.Univariate analysis and multivariate Logistic regression were used to identify influencing factors.Results Among 141 critically ill patients,66 cases developed RFS after nutritional support,and 75 cases did not develop RFS(non-RFS).Univariate analysis showed statistically significant differences in age,gender,tumor history,infection status,serum phosphorus,albumin,acute physiology and chronic health evaluationⅡ(APACHEⅡ)score,and the nutrition risk in critically ill(NUTRIC)score between these two groups(all P<0.05).Multivariate Logistic regression analysis identified male(OR=3.37,95%CI:1.19-9.59),infection(OR=3.87,95%CI:1.22-12.33),tumor history(OR=5.70,95%CI:1.33-24.54),the low albumin level(OR=0.89,95%CI:0.84-0.95),the low serum phosphate level(OR=0.10,95%CI:0.01-0.67),and high NUTRIC score on admission(OR=2.27,95%CI:1.50-3.42)as independent risk factors for RFS.Conclusion Gender,infection,tumor history,APTT,serum phosphate,albumin,and NUTRIC score are influencing factors for RFS in critically ill patients after nutritional support.
作者
韩丰泽
李小丽
于欣越
赵轩宇
贾紫菲
张晓丽
HAN Fengze;LI Xiaoli;YU Xinyue;ZHAO Xuanyu;JIA Zifei;ZHANG Xiaoli(The Second School of Clinical Medicine,Binzhou Medical University,Yantai 264000,China;不详)
出处
《山东医药》
2025年第5期47-51,共5页
Shandong Medical Journal
基金
山东省自然科学基金面上项目(ZR2021MH207)。
关键词
危重症
再喂养综合征
营养支持
影响因素
critical illness
refeeding syndrome
nutritional support
risk factors
作者简介
第一作者:韩丰泽(1999-),男,硕士研究生在读,主要研究方向为再喂养综合征。E-mail:hfz990113@163.com;通信作者:李小丽(1974-),女,博士研究生,主任医师,主要研究方向为重症感染多器官功能损伤。E-mail:zlfd999@163.com。
