Impact of early sequential enteral nutrition support on clinical outcomes in critical patients after cardiac surgery
早期序贯肠内营养支持对心脏外科术后重症患者临床疗效的影响

摘要

目的 本研究旨在评估早期序贯肠内营养支持对心脏外科术后重症患者的临床疗效，以期为临床实践提供新的证据和支持，优化心脏外科术后患者的营养支持方案，提高患者的康复质量和生存率。方法 本研究采用单中心、回顾性病例对照研究设计，纳入了符合条件的术后重症患者。研究通过严格的纳入和排除标准筛选患者，并将其分为病例组和对照组。病例组接受早期序贯肠内营养支持，即在术后6小时内启动短肽型肠内营养，并逐步过渡至整蛋白配方；而对照组则接受传统营养支持方案。研究过程中，密切关注了患者的机械通气时间、ICU住院日、免疫指标、肠道功能恢复时间以及喂养相关并发症发生率等关键指标，并采用SPSS 26.0进行数据分析。结果 研究结果表明，病例组在机械通气时间和ICU住院日上均显著低于对照组（P<0.05），表明早期序贯肠内营养支持有助于加快患者康复进程。在免疫指标方面，病例组的CRP和淋巴细胞计数恢复更快（P<0.05），肠道功能恢复时间也显著早于对照组（P<0.05）。在安全性方面，病例组的腹泻和误吸发生率略低于对照组，但差异无统计学意义（P>0.05）。结论 早期序贯肠内营养支持在心脏外科术后重症患者的营养管理中具有显著优势，能够显著缩短患者的机械通气时间和ICU住院日，加快康复进程，同时改善免疫功能和肠道功能，且安全性良好。本研究为临床实践提供了新的证据和支持，表明早期序贯肠内营养支持是一种安全、有效的营养支持方式，值得进一步推广和应用。

Abstract

Objective This study aimed to evaluate the clinical efficacy of early sequential enteral nutrition support (ESENS) in critical patients following cardiac surgery, with the goal of providing new evidence and guidance for optimizing postoperative nutritional support strategies and improving rehabilitation quality and survival rates.
Methods A single-center, retrospective case-control study was conducted involving eligible postoperative critical patients. Participants were rigorously screened using inclusion/exclusion criteria and divided into a case group and a control group. The case group received ESENS, initiating short-peptide-based enteral nutrition within 6 hours postoperatively and gradually transitioning to a whole-protein formula. The control group followed conventional nutritional support protocols. Key outcomes, including mechanical ventilation duration, ICU length of stay, immune indices (C-reactive protein [CRP] and lymphocyte counts), intestinal function recovery time, and feeding-related complication rates, were monitored. Statistical analysis was performed using SPSS 26.0.
Results The case group demonstrated significantly shorter mechanical ventilation time and ICU stay compared to the control group (P < 0.05), indicating accelerated recovery. Immune parameters showed faster normalization of CRP levels and lymphocyte counts in the case group (P < 0.05). Intestinal function recovery was also significantly earlier in the case group (P < 0.05). Regarding safety, the incidence of diarrhea and aspiration was numerically lower in the case group, though the difference was not statistically significant (P > 0.05).
Conclusion   ESENS exhibits notable advantages in nutritional management for critical patients after cardiac surgery, significantly reducing mechanical ventilation duration and ICU stay while enhancing immune and intestinal function recovery with favorable safety profiles. This study provides robust evidence supporting ESENS as a safe and effective nutritional strategy worthy of broader clinical application.