严重创伤患者疾病轨迹导向的营养管理方案构建与应用研究

doi:10.3761/j.issn.2096-7446.2025.04.005

Abstract

Abstract:

Objective To construct a nutritional management program based on the disease trajectory for severely injured patients and explore its application effects. Methods A non-synchronous before-and-after control study was conducted. Severely injured patients admitted to a tertiary class A hospital in Hangzhou from April to June 2023 were conveniently selected as the experimental group，and those admitted from January to March 2023 as the control group. The control group received a goal-directed early nutritional management program，while the experimental group received a nutritional management program based on the disease trajectory of severely injured patients. Nutritional-related indicators were compared between the two groups. Results A total of 84 patients were included in the experimental group and 87 in the control group. After the intervention，the experimental group had shorter initiation time for enteral nutrition support（t=2.335，P=0.017），fewer feeding interruption episodes within 7 d（Z=3.194，P=0.024），shorter feeding interruption duration（Z=3.865，P<0.001），lower blood glucose variability coefficient within 72 h（t=-2.432，P=0.016），and lower total insulin dosage（t=-4.664，P=0.035），and a lower incidence of feeding intolerance（χ²=5.554，P=0.021） compared to the control group. The 7 d target energy achievement rate（χ²=7.875，P=0.009） and serum prealbumin levels（t=4.129，P=0.016） were higher in the experimental group. Body composition analysis showed that the phase angle of the experimental group was higher than that of the control group（t=1.976，P=0.040）. There were no statistically significant differences in lean body mass，mechanical ventilation time，ICU length of stay，or improvement in the condition. Conclusion The program improve the implementation and quality of enteral nutrition，shorten the time to start enteral nutrition，enhance the target caloric achievement rate，and improve the nutritional status of severely injured patients，promoting their recovery.

Key words: Severe Trauma, Disease Trajectory, Precision Nutrition, Nursing Care

HUANG Xiaoxia, TANG Jiaying, JIANG Libing, GAO Mengke, ZHU Mengting, WU Longqin, FENG Xiuqin. Construction and application of a nutritional management program based on the disease trajectory for severely injured patients[J]. Chinese Journal of Emergency and Critical Care Nursing, 2025, 6(4): 414-420.

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References 22

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Construction and application of a nutritional management program based on the disease trajectory for severely injured patients

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