【摘要】 目的 探讨ICU机械通气患者实施联合序贯肠内营养支持治疗对营养指标以及安全性等相关因素的影响情况。方法 选取2022年2月18日—2023年2月18日郑州大学第一附属医院ICU收治的机械通气92例患者，按肠内营养方式不同，将实施整蛋白型肠内营养混悬液治疗的46例作为对照组，将实施联合序贯肠内营养支持治疗的46例作为联合组(整蛋白型肠内营养混悬液联合短肽型肠内营养混悬液),比较两组患者的恢复情况等相关指标变化。结果 (1)治疗前两组血红蛋白(Hb)、血清白蛋白(ALB)、上臂肌围(MAMC)及肱二头肌的皮皱厚度(TSF)水平比较无统计学意义(P>0.05),两组治疗后均升高，联合组Hb、ALB、MAMC及TSF水平分别为(122.30±6.11)g/L、(38.99±3.31)g/L、(22.42±2.61)mm和(9.98±1.98)mm,均高于对照组(P<0.05)。(2)联合组治疗后营养达标率和IgG水平为95.65%及(14.13±2.39)mg/mL,均高于对照组，住院时间[(7.49±2.40)d]少于对照组(P<0.05)。(3)不良反应总发生率比较联合组明显低于对照组(P<0.05)。(4)治疗前两组APACHEⅡ评分差异无意义(P>0.05),联合组治疗后APACHEⅡ评分(12.39±4.16)分，低于对照组，差异有统计学意义(P<0.05)。结论 ICU机械通气患者实施联合序贯肠内营养支持治疗，能改善营养指标，促进临床恢复，并降低不良反应发生率，缓解病情，可长期推广。更多还原

【Abstract】 Objective To investigate the effects of combined sequential enteral nutrition support therapy on nutritional indexes, safety and other related factors in patients with mechanical ventilation in ICU. Methods A total of 92 patients with mechanical ventilation admitted to ICU from February 18, 2022 to February 18, 2023 were selected. According to different methods of enteral nutrition, 46 patients receiving whole-protein enteral nutrition suspension treatment were selected as the control group. Forty-six patients receiving combined sequential enteral nutrition support therapy were selected as a combination group(whole protein type enteral nutrition suspension combined with short peptide type enteral nutrition suspension), and the recovery and other related indicators of the two groups were compared.Results(1) The levels of Hb, ALB, MAMC and TSF in the two groups before treatment were higher than those after treatment(P>0.05). The levels of Hb, ALB, MAMC and TSF in combination group were(122.30±6.11) g/L,(38.99±3.31) g/L,(22.42±2.61) mm and(9.98±1.98) mm, respectively, which were higher than those in control group(P<0.05).(2) After treatment, the nutritional compliance rate and IgG level of combination group were 95.65% and(14.13±2.39) mg/mL, which were higher than those of control group, and the length of hospitalization [(7.49±2.40) d] was lower than that of control group(P<0.05).(3) The total incidence of adverse reactions in combination group was significantly lower than that in control group(P<0.05).(4) There was no significant difference in APACHEⅡ score between the two groups before treatment(P>0.05), and the APACHEⅡ score of the combination group after treatment(12.39±4.16) was lower than that of the control group, and the difference was statistically significant(P<0.05). Conclusion Combined sequential enteral nutrition support therapy in patients with mechanical ventilation in ICU can improve nutritional indexes, promote clinical recovery, reduce the incidence of adverse reactions, alleviate the disease, and can be extended for a long time.更多还原