目的 明确重症监护（intensive care unit，ICU）患者再喂养综合征（refeeding syndrome，RFS）发生率及危险因素，为早期识别和预防再喂养综合征提供依据。方法 计算机检索国内外数据库中与ICU患者RFS发生率及危险因素相关的文献，检索时限为建库至2023年5月31日，利用Stata 17软件进行Meta分析。结果 共纳入21篇文献，总样本量5056例，阳性病例1935例，RFS发生率37.88%[95%CI(30.33%~45.43%)]。其中，年龄（MD=3.40）、合并糖尿病（OR=2.49）、体质量指数（MD=-1.21）、急性生理与慢性健康评分（MD=2.63）、序贯器官功能衰竭评分（MD=1.87）、格拉斯哥昏迷评分（MD=-2.53）、重症营养风险评分（MD=1.00）、血清磷水平（MD=-0.45）、血清钾水平（MD=-0.38）、血清钙水平（MD=-0.19）、血清钠水平（MD=-2.96）、白蛋白水平（MD=-1.64）、前白蛋白水平（MD=-67.83）等13项为ICU患者发生RFS的危险因素（均P＜0.01）。结论 护理人员可依据上述危险因素早期识别ICU患者RFS高发人群，及时采取针对性措施，从而改善患者的预后。

Objective To clarify the incidence and risk factors of refeeding syndrome(RFS) in Intensive Care Unit (ICU) patients,and to provide reference for early identification and prevention of RFS. Methods Literatures related to the incidence and risk factors of RFS in ICU patients were searched by computer in domestic and foreign databases. The retrieval time was from the inception to May 31,2023. Stata 17 software was used for meta-analysis.Results A total of 21 literatures with 5056 cases were included,with 1935 RFS cases. The incidence of RFS was 37.88%[95%CI(30.33%-45.43%)]. Among them,age (MD=3.40),combined diabetes (OR=2.49),BMI (MD=-1.21),acute physiology and chronic health evaluation Ⅱ(APACHEⅡ)(MD=2.63),sequential organ failure assessment (SOFA) (MD=1.87),Glasgow Coma Scale(GCS) (MD=-2.53),Critical nutritional risk score (NUTRIC) (MD=1.00),serum phosphorus level (MD=-0.45),serum potassium level (MD=-0.38),serum calcium level (MD=-0.19),serum sodium level (MD=-2.96),albumin level (MD=-1.64),and prealbumin level (MD=-67.83) were the risk factors (all P＜0.01).Conclusion Nursing staff can identify the ICU patients with high incidence of RFS in the early stage according to the results of the study,and take targeted measures in time to improve the prognosis of patients.

R47-05；R473