目的 探讨基于间接能量测定的营养支持对成人重症监护病房(intensive care unit, ICU)机械通气患者的应用价值。方法 选取苏州大学附属第四医院重症医学科2022年6-12月收治的机械通气患者42例为研究对象,按随机数字表法将其分为对照组18例和观察组24例。对照组实施肠内营养常规护理,观察组在间接能量测定指导下进行肠内营养支持。比较两组营养支持治疗前及治疗后第3天、第5天时血清白蛋白、前白蛋白、血红蛋白水平,以及机械通气时间、ICU住院时间、腹胀腹泻发生率。结果 观察组机械通气时间短于对照组(t=4.237,P<0.001)。两组血清白蛋白水平在时间、组间效应上比较,差异均有统计学意义(F_时间=11.990,F_组间=4.452,P均<0.05),两组腹胀腹泻发生率、ICU住院时间、前白蛋白及血红蛋白水平比较,差异均无统计学意义(P>0.05)。结论 基于间接能量测定的营养支持能提高ICU机械通气患者营养水平,缩短机械通气时间,值得临床推广应用。

Objective To explore the application value of nutritional support based on indirect energy measurement for the adult ICU mechanically ventilated patients. Methods Forty-two mechanically ventilated patients admitted to the intensive care medicine department of the fourth affiliated hospital of Soochow university between June and December 2022 were selected as the research subjects. They were divided into a control group(n=18) and an observation group(n=24), according to a random number table. The control group received enteral nutrition support according to the doctor′s advice, while the observation group was given enteral nutrition support based on the indirect energy measurement. Before nutritional support treatment and on the 3rd and 5th days after treatment, the levels of serum albumin, prealbumin, hemoglobin, mechanical ventilation time, ICU stay, and incidence of abdominal distension and diarrhea were compared between the two groups. Results The observation group had significantly shorter mechanical ventilation time and higher levels of serum albumin than that of the control group(t=4.237,P<0.001;F_groups=4.452, P<0.05). However, no significant differences were found between the two groups in the incidence of abdominal distension and diarrhea, ICU stay, and the levels of prealbumin and hemoglobin(all P>0.05). Conclusion Nutritional support based on indirect energy measurement can improve the nutritional level of ICU mechanically ventilated patients and shorten the duration of mechanical ventilation, which is worthy of clinical promotion and application.