基于能量代谢监测下肠内营养对老年危重症患者营养状态、肠道功能及免疫功能的影响

摘要 目的：探讨基于能量代谢监测下肠内营养（EN）对老年危重症患者肠道功能、营养状态、免疫功能的影响。方法：按照随机数字表法将南京市第一医院EICU 2020年4月~2023年1月期间收治的136例老年危重症患者分为对照组（常规EN）和研究组（基于能量代谢监测下接受常规EN），各为68例。对比两组临床指标、营养状态、免疫功能指标、肠道功能指标和并发症发生率。结果：研究组的7 d内EN达标率、7 d内撤机成功率高于对照组，研究组的ICU住院时间、机械通气时间短于对照组，并发症总发生率低于对照组（P<0.05）。干预14 d后，研究组的白蛋白（ALB）、血清总蛋白（TP）、前白蛋白（PA）及血红蛋白（Hb）水平高于对照组（P<0.05）。干预14 d后，研究组的免疫球蛋白（Ig）M、IgG及IgA水平高于对照组（P<0.05）。干预14 d后，研究组的D-乳酸、二胺氧化酶（DAO）水平低于对照组（P<0.05）。结论：基于能量代谢监测下EN干预老年危重症患者，可进一步改善患者的营养状态、肠道功能及免疫功能。

Effects of Enteral Nutrition Based on Energy Metabolism Monitoring on Nutritional Status, Intestinal Function and Immune Function in Elderly Critically Ill Patients

ABSTRACT Objective: To investigate the effects of enteral nutrition (EN) based on energy metabolism monitoring on intestinal function, nutritional status and immune function in elderly critically ill patients. Methods: According to the random number table method,136 elderly critically ill patients who were admitted to of EICU Department of Nanjing First Hospital from April 2020 to January 2023 were divided into control group (routine EN) and study group (routine EN based on energy metabolism monitoring), with 68 cases in each group. The clinical indexes, nutritional status, immune function indexes, intestinal function indexes and incidence of complications were compared between two groups. Results: The EN compliance rate within 7 days and the success rate of weaning within 7 days in study group were higher than those in control group, the ICU hospitalization time and mechanical ventilation time in study group were shorter than those in control group, and the total incidence of complications was lower than that in control group (P<0.05). 14 days after intervention, the levels of albumin (ALB), serum total protein (TP), prealbumin (PA) and hemoglobin (Hb) in study group were higher than those in control group (P<0.05). 14 days after intervention, the levels of immunoglobulin (Ig) M, IgG and IgA in study group were higher than those in control group (P<0.05). 14 days after intervention, the levels of D-lactic acid and diamine oxidase (DAO) in study group were lower than those in control group (P<0.05). Conclusion: EN intervention based on energy metabolism monitoring in elderly critically ill patients, which can further improve the nutritional status, intestinal function and immune function of patients.