中国当代儿科杂志2025，Vol.27Issue(3)：321-327,7.DOI:10.7499/j.issn.1008-8830.2409102
危重症患儿肠内营养喂养不耐受危险因素分析
Risk factors and development of a prediction model of enteral feeding intolerance in critically ill children
摘要
Abstract
Objective To explore the risk factors of feeding intolerance(FI)in critically ill children receiving enteral nutrition(EN)and to construct a prediction nomogram model for FI.Methods A retrospective study was conducted to collect data from critically ill children admitted to the Pediatric Intensive Care Unit of Xiangya Hospital,Central South University,between January 2015 and October 2020.The children were randomly divided into a training set(346 cases)and a validation set(147 cases).The training set was further divided into a tolerance group(216 cases)and an intolerance group(130 cases).Multivariate logistic regression analysis was used to screen for risk factors for FI in critically ill children receiving EN.A nomogram was constructed using R language,which was then validated on the validation set.The model's discrimination,calibration,and clinical net benefit were evaluated using receiver operating characteristic curves,calibration curves,and decision curves.Results Duration of bed rest,shock,gastrointestinal decompression,use of non-steroidal anti-inflammatory drugs,and combined parenteral nutrition were identified as independent risk factors for FI in critically ill children receiving EN(P<0.05).Based on these factors,a nomogram prediction model for FI in critically ill children receiving EN was developed.The area under the receiver operating characteristic curve for the training set and validation set was 0.934(95%CI:0.906-0.963)and 0.852(95%CI:0.787-0.917),respectively,indicating good discrimination of the model.The Hosmer-Lemeshow goodness-of-fit test showed that the model had a good fit(χ2=12.559,P=0.128).Calibration curve and decision curve analyses suggested that the model has high predictive efficacy and clinical application value.Conclusions Duration of bed rest,shock,gastrointestinal decompression,use of non-steroidal anti-inflammatory drugs,and combined parenteral nutrition are independent risk factors for FI in critically ill children receiving EN.The nomogram model developed based on these factors exhibits high predictive efficacy and clinical application value.关键词
喂养不耐受/肠内营养/危险因素/列线图/预测模型/儿童Key words
Feeding intolerance/Enteral nutrition/Risk factor/Nomogram/Prediction model/Child引用本文复制引用
周霞,高红梅,黄琳,韩辉武,胡红玲,李莜,虞仁和..危重症患儿肠内营养喂养不耐受危险因素分析[J].中国当代儿科杂志,2025,27(3):321-327,7.基金项目
湖南省自然科学基金面上项目(2024JJ5590) （2024JJ5590）
湖南省卫健委科研课题资助(202214044844). （202214044844）
