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目的 探讨加速康复外科（enhanced recovery after surgery，ERAS）理念指导下的早期肠内营养（early enteral nutrition，EEN）对重症监护室（intensive care unit，ICU）患者预后的影响。方法 采用回顾性队列研究设计，选取2024年1月—2024年12月苏州大学附属第一医院ICU收治的156例重症患者（预计机械通气≥48 h），按是否实施ERAS-EEN分为ERAS组与常规组，每组78例。ERAS组于入ICU 24 h内启动肠内营养（enteral nutrition，EN），联合促胃肠动力药、动态耐受监测及多学科协作；常规组于48 h后启动EN。比较两组28 d病死率、ICU住院时间、机械通气时间、EN达标率、并发症及炎症-营养指标。结果 ERAS组28 d病死率（15.38%）显著低于常规组（28.21%）（P=0.042）、ICU住院时间为（8.52±2.31）d，显著低于常规组的（11.87±3.45）d（P＜0.05），机械通气时间为（6.23±1.89）d，显著低于常规组的（9.45±2.76）d（P＜0.05）；EN 72 h达标率为82.05%，显著高于常规组的58.97%（P＜0.05）；ERAS组呕吐、吸入性肺炎及总体并发症发生率较常规组低，C-反应蛋白（C-reactive protein，CPR）、降钙素原（procalcitonin，PCT）下降幅度和白蛋白、前白蛋白回升幅度均优于常规组（P＜0.05）；两组肠缺血、腹泻、喂养不耐受发生率比较，差异无统计学意义（P＞0.05）。结论 ERAS-EEN可安全有效地降低ICU重症患者28 d病死率，缩短ICU住院及机械通气时间，提高营养达标率并减轻炎症反应，值得在多中心随机对照试验（randomized controlled trial，RCT）中进一步验证与推广。
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基本信息:
DOI：10.20256/j.cnki.zgdxbl.20260610.006
中图分类号:R459.3;R459.7
引用信息:
[1]丁秀秀,徐伟丽.基于ERAS理念的早期肠内营养对ICU重症患者预后的影响[J].中国典型病例大全().DOI:10.20256/j.cnki.zgdxbl.20260610.006.
2026-06-10
2026-06-10
2026-06-10