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目的 探讨老年脓毒症患者肠内喂养不耐受的影响因素，并构建风险预测模型。方法 选取2021年2月至2023年12月在某医院行肠内营养治疗的208例老年脓毒症患者为研究对象。根据是否发生肠内喂养不耐受分为耐受组（n=127）和不耐受组（n=81）。采用多元Logistic回归分析影响因素，构建预测模型并绘制列线图。结果 208例老年脓毒症患者中，81例（38.94%）发生肠内喂养不耐受。多元Logistic回归分析结果显示，肠内营养制剂日用量、急性生理学与慢性健康状况评分、镇静剂、镇痛剂、抗生素、腹内压、血糖、降钙素原、白蛋白是老年脓毒症患者肠内喂养不耐受的影响因素。内部验证显示，模型的一致性指数为0.955(0.929～0.982)。观测值与预测值较一致。列线图模型的阈值>0.06，所提供的临床净收益均高于各单一因素。结论 老年脓毒症患者肠内喂养不耐受问题仍需重视，基于影响因素构建的风险预测模型具有较高的临床实用价值，可为临床改善老年脓毒症患者肠内喂养不耐受提供科学依据。
Abstract：Objective To explore the influencing factors of enteral feeding intolerance in elderly patients with sepsis and to construct a risk prediction model.Methods A total of 208 elderly sepsis patients who underwent enteral nutrition therapy in a hospital from February 2021 to December 2023 were selected as study subjects.According to the occurrence of enteral feeding intolerance,patients were divided into a tolerance group(n=127) and an intolerance group(n=81).Multivariate Logistic regression analysis was used to analyze the influencing factors and a prediction model was constructed and visualized using a nomogram.Results Enteral feeding intolerance occurred in 81(38.94%) of 208 elderly septic patients.Multivariate Logistic regression analysis showed that daily dosage of enteral nutrition preparation,Acute Physiology and Chronic Health EvaluationⅡ sc ore,sedatives,analgesics,antibiotics,intra-abdominal pressure,blood glucose level,procalcitonin,albumin were significant influencing factors for enteral feeding intolerance in elderly patients with sepsis.Internal validation showed that the C-index of the model was 0.955(0.929～0.982).There was good agreement between the observed and predicted values.The threshold probability of the nomogram model was greater than 0.06,and the clinical net benefit were higher than that of each single predictor.Conclusion The issue of enteral feeding intolerance in elderly sepsis patients still requires attention.The risk prediction model constructed based on risk factors in this study has high clinical practical value and can provide a basis for improving enteral feeding intolerance in elderly sepsis patients in clinical practice.
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基本信息:
中图分类号:R473
引用信息:
[1]撒世颖,刘歆雨,李晓琦,等.老年脓毒症患者肠内喂养不耐受的风险预测模型构建[J].护理管理杂志,2026,26(04):300-303+310.
基金信息:
上海市东方医院天使培训计划（DFTS-2208）
2026-04-10
2026-04-10