营养支持小组对先天性心脏病手术患儿临床结局的影响

摘要

目的 探讨营养支持小组(NST)对先天性心脏病(简称先心病)手术患儿临床结局的影响.方法 2010年1月至2010年6月本院收治先心病手术患儿60例,以2010年3月NST介入治疗时为界,分为介入前(BET组)和介入后(AET组)两组,对两组患儿营养风险筛查比例、肠内营养应用比例、肠外营养“全合一”应用比例、术后呼吸机辅助呼吸时间、入住ICU时间、平均住院时间、营养直接相关费用、住院费用进行统计分析.结果 NST介入前、后进行营养风险筛查、应用肠内营养支持、肠外营养支持中应用“全合一”的比率分别为13.3％ (4/30)比100％ (30/30),43.3％ (4/30)比63.3％ (19/30),35.3％ (6/17)比100％ (11/11),AET组较BET组提高(x2值分别为132.11、19.65、24.73,均P＜0.05).介入前、后呼吸机辅助呼吸时间(7.03±1.76)h比(8.09±2.56)h、入住ICU时间(24.81 ±2.52)h比(37.01 ±3.47)h、平均住院时间(17.96±4.03)d比(19.60±4.53)d,营养相关费用(4 132.27±416.27)元比(2 754.03±323.47)元,住院费用(25 725.11±515.68)元比(31 975.53±600.56)元,差异均有统计学意义(t值分别为5.76、3.04、2.05、32.07、43.30,均P＜0.05).结论 NST是推动临床工作中进行规范、有效营养支持治疗,提高疾病治疗效果改善患者临床结局的有效方式.%Objective To investigate the effect of nutrition support team (NST) on the clinical outcomes in surgically treated children with congenital heart disease (CHD).Methods Totally 60 surgically treated CHD children from January 2010 to June 2010.In March 2010,they were divided into two groups based on the interventions:before the intervention (BET group) and after the intervention (AET group).Nutritional risk screening rate,enteral nutrition (EN) application rate,all-in-one parenteral nutrition (PN) application rate,postoperative mechanical ventilation time,length of ICU stay,average hospitalization days,expenses directly related to nutrition,and hospitalization expenses were compared between these two groups.Results The nutritional risk screening rate,EN application rate,and all-in-one PN application rates before and after intervention of NST were 13.3％ (4/30) vs 100％ (30/30),43.3％ (4/30) vs 63.3％ (19/30),and 35.3％ (6/17) vs 100％ (11/11),respectively,in AET group and BET group (x2 =132.11,19.65,and 24.73,respectively,all P ＜ 0.05).Mechanical ventilation time [(7.03 ± 1.76) h vs (8.09 ±2.56) h],length of ICU stay [(24.81 ±2.52) h vs (37.01 ±3.47) h],average hospitalization days [(17.96 ±4.03) d vs (19.60 ±4.53) d],nutritionrelated expenses [(4 132.27 ±416.27) yuan vs (2 754.03 ±323.47) yuan],and hospitalization expenses [(25 725.11 ±515.68) yuan vs (31 975.53 ±600.56) yuan] were also significantly favorable in AET group (t =5.76,3.04,2.05,32.07,and 43.30,respectively; all P ＜ 0.05).Conclusion NSP is an effective approach to promoting the standard efficacious nutrition support therapy in clinical settings and can improve the therapeutic effectiveness and clinical outcomes in surgically treated CHD children.