肠内营养支持患者误吸风险预测模型的研究进展

doi:10.3761/j.issn.2096-7446.2023.11.018

摘要/Abstract

摘要： 误吸是肠内营养的严重并发症之一,也是吸入性肺炎的首要原因,其发生会增加患者的病死率并延长住院时间,造成家庭和社会的经济负担。该文对肠内营养支持患者误吸风险预测模型的研究进展进行综述,从肠内营养误吸风险预测模型的基本情况、预测模型的比较分析及对未来的启示等方面进行介绍,以期为临床医护人员评估和预测患者的误吸风险提供合适的模型,为实现误吸的早期预防、及时干预提供参考依据。

关键词: 肠道营养, 鼻饲, 呼吸道误吸, 模型, 统计学, 综述文献（主题）, 危重病护理

Abstract: Aspiration is one of the serious complications of enteral nutrition and is the leading cause of aspiration pneumonia,the occurrence of which increases patient mortality and prolongs hospitalization,affects economic burden of family and society. This paper reviews the research progress of the risk prediction models for aspiration in patients with enteral nutrition support,and introduces the basic situation of the risk prediction model for aspiration in enteral nutrition,the comparative analysis of the prediction models,and the revelation for the future,with the aim of providing a suitable model for the clinical health care personnels to assess and predict the risk of aspiration in patients,and providing a reference basis to realize the early prevention and timely intervention of aspiration

Key words: Enteral Nutrition, Nasogastric Feeding, Respiratory Aspiration, Models, Statistical, Review Literature as Topic, Critical Care Nursing

左俊焘, 叶向红, 李嘉琪, 徐瑶. 肠内营养支持患者误吸风险预测模型的研究进展[J]. 中华急危重症护理杂志, 2023, 4(11): 1052-1056.

ZUO Juntao, YE Xianghong, LI Jiaqi, XU Yao. Research progress on risk prediction models of aspiration in patients with enteral nutrition support therapy[J]. Chinese Journal of Emergency and Critical Care Nursing, 2023, 4(11): 1052-1056.

参考文献

[1] 米元元,沈月,王宗华,等. 机械通气患者误吸预防及管理的最佳证据总结[J]. 中华护理杂志,2018,53(7):849-856.
Mi YY,Shen Y,Wang ZH,et al.Evidence summary for aspiration patients receiving mechanical ventilation[J]. Chin J Nurs,2018,53(7):849-856.
[2] 王江玲,戴新娟,施琪,等. 我国脑卒中误吸研究的文献计量学分析[J]. 护理研究,2018,32(9):1475-1477.
Wang JL,Dai XJ,Shi Q,et al.Research of aspiration after stroke in China:a bibliometric analysis[J]. Chin Nurs Res,2018,32(9):1475-1477.
[3] Thomas LE,Lustiber L,Webb C,et al.Aspiration prevention:a matter of life and breath[J]. Nursing,2019,49(3):64-66.
[4] 肖茗芳,刘明超,谢艳梅. ICU患者微误吸的相关因素及护理研究进展[J]. 中华急危重症护理杂志,2023,3(4):320-324.
Xiao MF,Liu MC,Xie YM.Research progress on related factors and nursing care of micro-aspiration in ICU patients[J]. Chin J Emerg Crit Care Nurs,2023,3(4):320-324.
[5] Au EH,Francis A,Bernier-Jean A,et al.Prediction modeling-part 1:regression modeling[J]. Kidney Int,2020,97(5):877-884.
[6] 叶向红,许冰茹,王慧君,等. 重症病人早期肠内营养误吸风险评估表的构建[J]. 肠外与肠内营养,2019,26(6):346-350.
Ye XH,Xu BR,Wang HJ,et al.Establishment of risk assessment table for early enteral nutrition aspiration in severe patients[J]. Parenter Enter Nutr,2019,26(6):346-350.
[7] 刘璐,张娟,张晓瑜,等. 鼻饲患者误吸风险评估量表的编制及信效度检验[J]. 中华护理杂志,2022,57(3):337-342.
Liu L,Zhang J,Zhang XY,et al.Development of an Assessment Scale of Aspiration Risk for Nasal Feeding Patients and its test of validity and reliability[J]. Chin J Nurs,2022,57(3):337-342.
[8] Sun WJ,Xie LL,Chen LM,et al.Development and validation of two aspiration prediction models in patients receiving nasogastric feeding[J]. J Nurs Manag,2020,28(6):1372-1380.
[9] 张菊红,季亚萍,魏海霞. 基于决策树和列线图构建鼻饲病人误吸风险预测模型的研究[J]. 循证护理,2022,8(7):971-975.
Zhang JH,Ji YP,Wei HX.Research on the prediction model of aspiration risk of nasal feeding patients based on decision tree and Nomogram[J]. Chin Evid Based Nurs,2022,8(7):971-975.
[10] 官艳,王旋,洪琳,等. 重症急性胰腺炎患者早期肠内营养误吸风险预测模型的构建[J]. 护理学杂志,2022,37(8):94-96.
Guan Y,Wang X,Hong L,et al.Construction of early enteral nutrition aspiration risk prediction model in patients with severe acute pancreatitis[J]. J Nurs Sci,2022,37(8):94-96.
[11] 官艳,张国娇,罗茵. 基于机器学习算法构建重症急性胰腺炎病人肠内营养误吸风险的预测模型[J]. 临床外科杂志,2022,30(7):634-638.
Guan Y,Zhang GJ,Luo Y.Establishment and validation of early enteral nutrition aspiration risk prediction model for patients with severe acute pancreatitis based on machine learning algorithm[J]. J Clin Surg,2022,30(7):634-638.
[12] 彭宇,沙丽艳,刘子龙,等. 重症脑出血患者肠内营养支持发生误吸风险预测模型的构建及验证[J]. 中国护理管理,2022,22(9):1391-1397.
Peng Y,Sha LY,Liu ZL,et al.Construction and validation of risk prediction model for aspiration in patients with severe intracerebral hemorrhage receiving enteral nutrition support[J]. Chin Nurs Manag,2022,22(9):1391-1397.
[13] 余灵芝,林兴,朱秀梅,等. 基于列线图构建重症颅脑损伤患者肠内营养误吸风险预测模型研究[J]. 创伤与急危重病医学,2022,10(6):467-470.
Yu LZ,Lin X,Zhu XM,et al.Research on the prediction model of enteral nutrition aspiration risk of patients with severe craniocerebral injuries based on decision tree and Nomogram[J]. Trauma Crit Care Med,2022,10(6):467-470.
[14] 郑丹妮,王红霞,蔡淑虹,等. 鼻饲喂养高龄患者肺部感染的预测模型建立及评价[J]. 中华医院感染学杂志,2023,33(4):637-640.
Zheng DN,Wang HX,Cai SH,et al.Establishment and evaluation of predictive model for pulmonary infection in elderly patients receiving nasal feeding[J]. Chin J Nosocomiology,2023,33(4):637-640.
[15] 孙文静,谢莉玲,黄龙贤,等. 鼻饲患者两种误吸风险预测模型的外部验证及比较[J]. 中华护理杂志,2021,56(9):1352-1356.
Sun WJ,Xie LL,Huang LX,et al.External validation and comparison of 2 aspiration risk prediction models in patients receiving nasogastric feeding[J]. Chin J Nurs,2021,56(9):1352-1356.
[16] DiBardino DM,Wunderink RG. Aspiration pneumonia:a review of modern trends[J]. J Crit Care,2015,30(1):40-48.
[17] 中华医学会重症医学分会. 中国成人ICU镇痛和镇静治疗指南[J]. 中华重症医学电子杂志(网络版),2018,4(2):497-514.
Critical Care Medicine Branch of Chinese Medical Associa-tion. Guidelines for analgesia and sedation treatment in intensive care unit of Chinese adults[J]. Chin J Crit Care Inten-sive Care Med Electron Ed,2018,4(2):497-514.
[18] Scolapio JS.Decreasing aspiration risk with enteral feeding[J]. Gastrointest Endosc Clin N Am,2007,17(4):711-716.
[19] Murray A,Mulkerrin S,O'Keeffe ST. The perils of ‘risk feeding’[J]. Age Ageing,2019,48(4):478-481.
[20] Zhou J,Chen W,Liu Y,et al.Trajectories of lymphocyte counts in the early phase of acute pancreatitis are associated with infected pancreatic necrosis[J]. Clin Transl Gastroenterol,2021, 12(9):e00405.
[21] McClave SA,DeMeo MT,DeLegge MH,et al. North American Summit on Aspiration in the Critically Ill Patient:consensus statement[J]. JPEN J Parenter Enteral Nutr,2002,26(6 Suppl):S80-S85.
[22] Jalali A,Foley RW,Maweni RM,et al.A risk calculator to inform the need for a prostate biopsy:a rapid access clinic cohort[J]. BMC Med Inform Decis Mak,2020,20(1):1-11.
[23] 蒋伟红,金陈娣,李帅妮,等. 先天性心脏病术后患儿中心静脉导管相关深静脉血栓风险预测模型的构建及验证[J]. 中华护理杂志,2022,57(18):2217-2224.
Jiang WH,Jin CD,Li SN,et al.Construction and validation of a risk prediction model for central venous catheter-associated deep venous thromboses in children with congenital heart disease after surgery[J]. Chin J Nurs,2022,57(18):2217-2224.