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戚桂艳.基于容量的喂养策略对合并2型糖尿病重症患者有益[J].内科急危重症杂志,2025,31(4):321-324
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| DOI：10.11768/nkjwzzzz20250406 |
| 中文关键词: 基于容量的喂养 肠内营养 重症 糖尿病 |
| 英文关键词: |
| 基金项目:沧州市重点研发计划指导项目（204106003） |
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| 摘要点击次数: 10 |
| 全文下载次数: 13 |
| 中文摘要: |
| 摘要 目的：观察基于容量的喂养策略对合并2型糖尿病的重症患者的影响。方法：前瞻性选取重症医学科（ICU）需要进行肠内营养及机械通气的67例2型糖尿病患者，将患者随机分为2组，治疗组34例，采用基于容量的喂养策略（VBF），制定每日目标喂养容量，根据胃肠道耐受性调整喂养速率；对照组33例，采用传统的基于速率的喂养策略（RBF），以恒定的速率进行喂养。观察2组患者热量及蛋白质的摄入量、ICU住院时间、总住院时间、死亡率和机械通气的天数，观察2组血糖情况。结果：治疗组中实际摄入的热量占目标热量的百分比明显高于对照组（P<0.01），摄入的蛋白质明显多于对照组（P<0.01），机械通气时间明显短于对照组(P<0.05)。2组之间血糖变异系数、住ICU时间、总住院时间及死亡率差异无统计学意义。结论：基于容量的喂养策略可以为ICU 2型糖尿病患者提供更多的热量及蛋白质，缩短机械通气时间，而不引起明显血糖波动。 |
| 英文摘要: |
| Abstract Objective: To observe the effects of a volume-based feeding (VBF) strategy on critically ill patients with type 2 diabetes mellitus (T2DM). Methods: A prospective study was conducted on 67 T2DM patients requiring enteral nutrition and mechanical ventilation in the intensive care unit (ICU). Patients were randomly divided into two groups: the treatment group (n=34) receiving a VBF strategy, where a daily target feeding volume was set and the feeding rate was adjusted based on gastrointestinal tolerance; the control group (n=33) receiving a traditional rate-based feeding (RBF) strategy at a constant rate. Caloric and protein intake, ICU length of stay (LOS), total hospital LOS, mortality, days of mechanical ventilation, and glycemic status were observed and compared between the two groups. Results: The percentage of actual caloric intake relative to target calories was significantly higher in the treatment group than in the control group (P< 0.01). Protein intake was also significantly greater in the treatment group (P< 0.01), and the duration of mechanical ventilation was significantly shorter than in the control group (P< 0.05). There were no statistically significant differences between the two groups in glycemic variability coefficient, ICU LOS, total hospital LOS, or mortality. Conclusion: The volume-based feeding strategy can provide more calories and protein, and shorten the duration of mechanical ventilation for ICU patients with T2DM, without causing significant glycemic fluctuations. |
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