早期腸道營養對內科重症老人預後之探討

Enteral Nutrition on Clinical Outcomes in Medical Critically Ill Geriatric Patients

林晏如(Yan-Ju Lin) ； 陳玉如(Yu-Ju Chen) ； 葉玲岑(Ling-Tsen Yeh) ； 李靜怡(Chun-Yi Lee) ； 王秀媛(Hsiu-Yuan Wang)

《重症醫學雜誌》 12卷1期 (2011/03) Pp. 1-8

https://doi.org/10.30035/TCCM.201103.0001

摘要

目的：本研究主要目的是調查國內內科重症老年人早期腸道營養對預後之影響。方法：本研究爲回溯性研究，調查2006年7月至2006年11月某醫學中心的內科加護病房，共有72名年齡大於65歲的腸道灌食病人，以入加護病房48小時內有否接受腸道餵食定義爲早期或晚期餵食。探討開始腸道餵食時間對預後包括熱量和蛋白質攝取、死亡率、加護病房天數和住院天數之影響。結果：58個病人(80.6%)爲早期餵食組，14個病人(19.4%)爲晚期餵食組，早期餵食組在熱量和蛋白質攝取顯著高於晚期餵食組（1221.3±427 vs. 690.9±448大卡，P=0.001; 54.2±19.2 vs. 30.9±19.7公克，P=0.001），在加護病房天數顯著低於晚期餵食組（9.3±6.9 vs. 15.4±8.5天，P=0.022），但在住院天數和死亡率並無統計差別（35.6±29.5 vs. 28.8±19.5天，P=0.309; 31.8% vs. 50%, P=0.06）。結論：腸道營養爲重症病人主要的營養支持，早期腸道營養對內科重症老年人可改善營養攝取和減少加護病房天數。

關鍵字

早期腸道營養 ； 加護病房 ； 重症 ； 老年人

並列摘要

Objectives: The major purpose of this study was to investigate the correlation between early enteral nutrition and outcomes in critically ill geriatric patients.Methods: This retrospective study was conducted in a medical center, medical charts of 72 subjects, who were 65 years of age or older, received enteral feeding and admitted into the medical intensive care unit during July to Novemeber 2006, were reviewed. Patients were classified into the early and late feeding groups according to whether or not received enteral feeding within 48 hrs of admission. Measurements of this study included: daily calorie and protein intake, mortality, the length of intensive care unit stay and the length of hospital stay which were collected from medical charts.Results: 58 (80.6%) and 14 (19.4%) patients were classified into the early feeding group and the late feeding group, respectively. Daily calories and protein intake was significantly higher than late feeding group. (1221.3±427 vs. 690.9±448 kcal, P=0.001; 54.2±19.2 vs. 30.9±19.7 g, P=0.001) The early feeding group had significantly shorter length of intensive care unit stay compared with the late feeding group (9.3±6.9 vs. 15.4±8.5 days, P=0.022). There was no statistical difference in mortality and the length of hospital stay between two groups (35.6±29.5 vs. 28.8±19.5 days, P=0.309; 31.8% vs. 50%, P=0.06).Conclusions: The results suggest that early enteral nutrition can improve nutritional intakes and reduce the length of intensive care unit stay in critically ill geriatric patients.

並列關鍵字

Early enteral nutrition ； Intensive care unit ； Critically ill ； Geriatric ； Outcomes