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中国科技核心期刊（中国科技论文统计源期刊）
中国科学引文数据库（CSCD）核心库期刊
《中文核心期刊要目总览》核心期刊

中国护理管理 ›› 2025, Vol. 25 ›› Issue (8): 1181-1187.doi: 10.3969/j.issn.1672-1756.2025.08.012

• 改善护理服务行动专题 • 上一篇    下一篇

危重症患者肠内营养治疗后管饲依赖居家戒断方案的应用

郭春秀 张聪慧 黄艳林 叶蕾 许程飞 向洋 寇金萍 倪崴莲   

  1. 天津市第三中心医院重症医学科，300170 天津市
  • 出版日期:2025-08-15 发布日期:2025-08-15
  • 通讯作者: 倪崴莲，本科，主管护师，护士长，E-mail:773002567@qq.com
  • 作者简介:郭春秀，硕士，主管护师
  • 基金资助:
    天津市卫生健康科技项目（TJWJ2022XK028）；天津市医院协会医院管理研究项目（2024zc044）

Application of home withdrawal plan for critically ill patients with enteral nutrition therapy and tube feeding dependence

GUO Chunxiu, ZHANG Conghui, HUANG Yanlin, YE Lei, XU Chengfei, XIANG Yang, KOU Jinping, NI Weilian   

  1. Intensive Care Unit, Tianjin Third Central Hospital, Tianjin, 300170, China
  • Online:2025-08-15 Published:2025-08-15
  • Contact: E-mail:773002567@qq.com

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摘要： 目的：评价居家戒断方案在危重症肠内营养治疗后管饲依赖患者中的应用效果，为帮助患者早期戒断管饲提供参考。方法：通过查阅文献和德尔菲专家函询，构建危重症患者肠内营养治疗后管饲依赖居家戒断方案，采用便利抽样法，选取2024年8月—11月在天津市某三级甲等医院重症医学科一病区肠内营养治疗后管饲依赖的31例患者为干预组，在常规随访基础上给予居家戒断方案随访；以二病区肠内营养治疗后管饲依赖的30例患者为对照组，给予常规随访。于干预7天、1个月时评估患者管饲依赖症状评分，于干预1个月时评估患者生活质量、体质量并统计患者管饲戒断成功、误吸、呕吐、腹胀、腹泻发生例数。结果：重复测量方差分析结果显示，不同时间点两组患者管饲依赖症状评分比较，交互效应具有统计学意义（P<0.001）；干预1个月时，干预组管饲依赖评分（34.61±6.01）分低于对照组的（50.20±12.79）分，差异具有统计学意义（P<0.001）；两组生活质量比较，差异有统计学意义（P<0.05）；干预组管饲戒断成功例数多于对照组，误吸、呕吐、腹胀、腹泻发生例数均少于对照组，差异有统计学意义（均P<0.001）；干预组体质量减少量明显低于对照组，差异有统计学意义（P<0.001）。结论：危重症患者肠内营养治疗后管饲依赖居家戒断方案具有科学性、安全性与可行性，在帮助患者恢复经口进食、减轻管饲依赖症状、提高生活质量等方面得到初步验证。

关键词: 危重症患者；肠内营养；管饲依赖；居家戒断

Abstract: Objective: To evaluate the application effects of home withdrawal program in critically ill patients with tube feeding dependence after enteral nutrition treatment, and to provide reference for helping patients with early withdrawal tube feeding. Methods: Through literature review and Delphi expert consultation, a home-based withdrawal program for tube feeding dependence after enteral nutrition therapy in critically ill patients was constructed. From August to November 2024, a total of 31 patients with tube feeding dependence after enteral nutrition therapy in Ward 1 of the Intensive Care Unit at a tertiary grade A hospital in Tianjin were selected as the intervention group and received a home withdrawal plan based on routine follow-up. In Ward 2, a total of 30 patients with tube feeding dependence after enteral nutrition treatment were selected as the control group, and received routine follow-up. Results: The results of repeated measures analysis of variance showed that there were significant differences in the scores of tube feeding dependence symptoms between the two groups at different time points (P<0.001). After 1 month of intervention, the score of tube feeding dependence in the intervention group (34.61±6.01) was lower than that in the control group (50.20±12.79), and the difference was statistically significant (P<0.001). There was significant difference in quality of life between the two groups (P<0.05). The successful cases of tube feeding withdrawal in the intervention group were more than those in the control group, and the cases of aspiration, vomiting, abdominal distension and diarrhea were less than those in the control group, with statistically significant differences (P<0.001). The weight loss of the intervention group was significantly lower than that of the control group, and the difference was statistically significant (P<0.001). Conclusion: The home withdrawal program of tube feeding dependence after enteral nutrition treatment in critically ill patients is scientific, safe and feasible. It has been preliminarily verified in helping patients to restore oral feeding, reduce the symptoms of tube feeding dependence and improve the quality of life.

Key words: critically ill patients; enteral nutrition; tube feeding dependence; home withdrawal

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