Analysis of risk factors for enteral nutrition intolerance in patients with severe acute cerebral infarction
10.3760/cma.j.cn115455-20250427-00381
- VernacularTitle:重症急性脑梗死患者肠道营养不耐受的危险因素分析
- Author:
Jingling XU
1
;
Yifan SHENG
1
;
Hang YU
1
Author Information
1. 舟山医院重症医学科，舟山 316000
- Publication Type:Journal Article
- Keywords:
Brain infarction;
Critical illness;
Enteral nutrition;
Feeding intolerance;
Risk factors
- From:
Chinese Journal of Postgraduates of Medicine
2025;48(12):1122-1126
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the risk factors of enteral nutrition (EN) intolerance in patients with severe acute cerebral infarction (ACI) and analyze its impact on postoperative neurorehabilitation.Methods:A retrospective selection was made of 199 patients with severe ACI admitted to Zhoushan Hospital from January 2022 to May 2024. According to whether the patients developed feeding intolerance, they were divided into the feeding intolerance group (90 cases) and the feeding tolerance group (109 cases). The clinical data of the two groups were compared. Multivariate Logistic regression analysis was used to analyze the independent risk factors of feeding intolerance in patients with severe ACI, and the impact of EN intolerance on the National Institutes of Health Stroke Scale (NIHSS) score was analyzed.Results:The age, bed rest time, EN speed and Acute Physiology and Chronic Health EvaluationⅡ(APACHEⅡ) score in the feeding intolerance group were higher than those in the feeding tolerance group: (71.54 ± 11.44) years vs. (67.83 ± 13.82) years, (67.83 ± 13.82) d vs.(17.11 ± 8.41)d ,(61.50 ± 10.34) ml/h vs.(57.48 ± 7.95) ml/h,(22.68 ± 4.73) scores vs.(21.25 ± 5.12) scores; and the proportion of consciousness disorder and gastric tube use were higher than those in the feeding tolerance group: 56.7%(51/90) vs. 36.7%(40/109), 97.8%(88/90) vs. 89.0%(97/109); there were statistical differences ( P<0.05). The results of multivariate Logistic regression analysis indicated that old age, consciousness disorder, faster EN speed, and the use of gastric tubes were independent risk factors for EN intolerance in patients with severe ACI ( P<0.05). At 7 d after the start of EN, the total serum protein and hemoglobin in the feeding intolerance group were lower than those in the feeding tolerance group : (62.09 ± 6.07) g/L vs. (63.70 ± 5.34) g/L, (118.60 ± 17.01) g/L vs. (124.69 ± 18.51) g/L; and the scores of NIHSS was higher than that in the feeding tolerance group: (14.89 ± 7.68) scores vs. (12.40 ± 8.97) scores, there were statistical differences ( P<0.05). Conclusions:Old age, consciousness disorders, fast EN speed and the use of gastric tubes are risk factors for EN intolerance in severe ACI patients.
