序贯营养治疗在一例成年神经源性肠患者的应用
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江苏省人民医院(南京医科大学第一附属医院)

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Sequential Nutrition Therapy in Neurogenic Bowel Dysfunction
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    摘要:

    目的:探索成年神经源性肠患者的营养治疗,评价序贯营养治疗思路的干预效果。 方法:选取2021年9月收治的1例成年“神经源性肠,不可归在他处者”患者作为研究对象,采用序贯营养治疗结合肠道功能康复训练、肠道管理护理干预,比较干预前后患者胃肠道反应发生情况、营养素摄入情况、营养状况评价(总蛋白TP,白蛋白Alb,血红蛋白Hgb)。结果:干预后患者胃肠道功能障碍明显改善,总营养素摄入量、肠内营养素摄入量、患者目标营养需求满足水平均显著提升,营养制剂补充形式更为合理,三大产能营养素供能比例更为契合。干预后患者营养状况基本同前,TP与总能量摄入量、总蛋白质、肠内蛋白质摄入量的负相关性最强(Co1=-0.92, Co2=-0.88, Co3=-0.85),血清Alb水平和肠内营养蛋白质供给量之间存在一般负相关(Co=-0.49),Hgb水平和总蛋白质摄入量之间存在一般负相关关系(Co=-0.42),其余未见明显联系。结论:序贯营养治疗对成年神经源性肠患者而言,可有效改善胃肠功能障碍、提升消化系统功能、改善营养需求满足程度,对患者目标营养需求的计算和实际营养干预方案的优化有待进一步探索。

    Abstract:

    【Abstract】Objective: Evaluate the intervention effect of sequential nutrition therapy for patients with Neurogenic Bowel Dysfunction (NBD). Methods: Selected one patient with "NBD, irretrievable elsewhere" admitted in September 2021 as the research object. Sequential nutrition therapy combined with bowel function rehabilitation training and bowel management nursing intervention were used to relief the gastrointestinal symptoms. The occurrence of patient`s gastrointestinal reactions, nutrient intake, and nutrition status evaluation (total protein, albumin, hemoglobin) before and after were analyzed. Results: After the intervention, the gastrointestinal dysfunction was significantly improved. The total nutrient intake, as well as the enteral nutrient intake was promoted to meet the patient's target needs. The absorption of nutrients was more reasonable with a more appropriate intake ratio of Carbohydrate, Protein and Fat. However, the nutrition status of the patients was basically the same after this nutrition therapy. The strongest negative correlation appeared between TP and total energy intake, TP and total protein, as well as TP and enteral protein intake (Co1=-0.92, Co2=-0.88, Co3=-0.85). Conclusion: Sequential nutrition therapy can effectively relieve gastrointestinal dysfunction, promote digestive system function, and improve the satisfaction of nutritional needs for adult patients with neurogenic bowel. Its role of improving nutrition status of NBD patients needs to be further explored.

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  • 收稿日期:2022-03-29
  • 最后修改日期:2022-09-30
  • 录用日期:2023-05-10
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