| Objective:The clinical effects of intermittent infusion method and continuous infusion method based on meridional fluid infusion theory in ICU patients with multiple injuries were compared,providing theoretical basis for selecting rational enteral nutrition infusion method for ICU patients with multiple injuries.By comparing and analyzing the intermittent and continuous infusion methods in ICU patients with multiple injuries,the optimal infusion method to improve nutritional compliance rate and enteral nutritional tolerance of ICU patients with multiple injuries was discussedMethods:(1)Case selection:From January 1,2018 to December 1,2018,patients with multiple injuries who were hospitalized in an ICU of a third-grade a hospital were selected as research objects.64 patients who met the clinical diagnostic criteria,inclusion criteria and exclusion criteria were selected through convenient sampling method,and were divided into intermittent group and continuous group(2)Infusion methods:(the treatment plans of the two groups were the same)intermittent nutrition pump infusion was given to the intermittent group(three times a day,and the infusion was conducted at three time periods,respectively,from 7:00 to 11:00,from 15:00 to 19:00,and from 23:00 to 3:00,according to the meridional flow theory of traditional Chinese medicine).Sustained group:24 hours sustained nutrition pump infusion(3)Observation indexes:main observation indexes of the two groups after nasal feeding:serum albumin,neutrophils,blood glucose fluctuation range,alanine aminotransferase;Secondary outcome measures:(Nutrison Fibre)energy supply and intestinal tolerance scores;Length of stay in hospital,duration of mechanical ventilation,monitoring value of intra-abdominal pressure,gastric residual volume(4)Statistical analysis:SPSS20.0 software was used for statistical analysis Measurement data subject to normal distribution were described as mean ± standard deviation,and the difference between the two groups was tested by t test with two independent samples.Frequency and composition ratio or rate were used to describe the counting data,and the differences between the two were tested by x2 test.Repeated measurement anova was used to observe the gastrointestinal nutritional tolerance scores on the 1st,3rd,7th and 14th days of nasal feeding respectively to observe the two methods and time effects.The test level was set as a=0.05,meaning P<0.05 was considered statistically significantResults:(1)The main observation indexes of intermittent and continuous infusion in ICU patients with multiple injuries:the difference of albumin between the two groups on the first day of nasal feeding and the 14th day of nasal feeding was statistically significant(P<0.05).The difference of neutrophils between the two groups was statistically significant(P<0.05).There were statistically significant differences in the amplitude of blood glucose fluctuations between the two groups(P<0.05).The difference of transaminase between the two groups was statistically significant(P<0.05)(2)Nutritional compliance in ICU patients with multiple injuries in the intermittent group and the continuous group:there was a statistically significant difference in the time of full energy intake between the two groups(P<0.05),the mean difference in energy supply(full capacity)between the two groups(P<0.05),and the difference in nutritional improvement rate between the two groups(P<0.005)(3)Improvement of patients with multiple injuries in the intermittent group and the continuous group:the difference in average hospital stay between the two groups was statistically significant(P<0.05),the difference in mechanical ventilation time between the two groups was statistically significant(P<0.05)(4)Complications of patients with multiple injuries in the intermittent group and the continuous group:there was no statistically significant difference in the incidence of complications between the two groups(P>0.05).(5)Feeding tolerance of patients with multiple injuries with intermittent and continuous infusion:there were statistically significant differences in intestinal tolerance score,intestinal rumble and intra-abdominal pressure between the two infusion methods after 14 days of nasal feeding(P<0.05).(6)Method of intermittent or continuous infusion in ICU patients with multiple trauma of many factors affecting the tolerability of enteral nutrition analysis:effects on gastrointestinal nutrition tolerance factors using multiple linear regression,the dependent variable for gastrointestinal tolerance grade,independent variables as age,gender,marital status,category and the indicators on admission to hospital,variable selection method using stepwise regression method(α入=0.05,α出=0.1).In the regression results,the corrected determination coefficient R2=0.603,indicating that this variable(i.e.,intermittent)can explain 60.3%of the total variation of gastrointestinal tolerance score,and the model fitting effect is good.The gastrointestinal tolerance score of patients in the intermittent group was 1.7 points lower on average than that in the continuous group,with 95%CI(-2.21,-1.24).Conclusion:(1)The intermittent group based on the Midnight-noon Ebb-flow theory of traditional Chinese medicine was better than the continuous group in albumin synthesis ability,maintenance of immunity,enhancement of anti-infection ability and improvement of blood glucose.(2)Patients in the intermittent group who are based on the theory of Midnight-noon Ebb-flowof traditional Chinese medicine have various examinations and early activities,which can ensure the energy supply of enteral nutrition reaches the standard.(3)The duration of hospitalization and mechanical ventilation in the intermittent group were shorter than those in the continuous group.(4)The nutritional tolerance of patients in the intermittent group based on the Midnight-noon Ebb-flow theory of traditional Chinese medicine was better than that in the continuous group. |
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