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Refeeding syndrome(RFS)has a high incidence among critically ill patients and significantly impacts the re-covery and prognosis of the patients.In this paper,we reviewed the literature on the risk factors and risk prediction models for RFS,finding the risk factors of RFS included patient-related,treatment-related factors and disease-related factors and the risk prediction models encompassed risk stratification model,risk score models and the Logistic regression models.It was concluded from the review that early assessment was crucial to preventing the occurrence of RFS.However,there was still a lack of reliable RFS risk prediction models with good predictive performance.It was found as well that it was crucial for the prevention of RFS to attach importance to nutritional and serological indicators and other factors.It was expected to be a necessity to conduct prospec-tive and multicenter studies to develop a risk prediction model for predicting RFS for ICU patients.Our review provides a refer-ence for early assessment and intervention for critically ill patients with RFS.
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Objective To explore the influence of maternal free position combined with duole tools during the first labor stage on birth outcomes.Methods 600 normal pregnant women who were routinely examined in our hospital from May 2016 to December 2016 were selected.They were randomly divided into observation group and control group according to the number of prenatal date of pregnant women,each group in 300 cases.The control group was taken routine supine position in the first labor stage.The observation group used free position with duole tools during the first labor stage.The maternal first labor time,delivery mode,neonatal asphyxia,postpartum hemorrhage,maternal reproductive tract injury were observed.The maternal postpartum within 2 hours,the pain score,maternal childbirth response scale (CCB) and anxiety by comprehensive hospital anxiety and depression table (HAD) were assessed.Results The spontaneous delivery rate and tolerable pain of the observation group were 90.0％(270/300) and 73.7％ (221/300) respectively,which were higher than those of the control group [83.3％(250/300) and 62.0％ (186/300)].The maternal perineum II degree laceration and neonatal asphyxia rates of the observation group were 8.3％(25/300) and 1.7％ (5/300) respectively,which were lower than thsoe of the control group [12.3％(37/300) and 4.3％ (13/300) respectively],the differences were statistically significant(χ2=9.31,9.84,9.05,8.39,all P＜0.05).The maternal first labor time and postpartum hemorrhage of the observation group were (10.87±3.06)h and (121.60±15.11) mL,respectively,which were significantly lower than those of the control group [(11.69±2.48)h and (180.52±14.76)mL],the differences were statistically significant (t=8.92,9.74,all P＜0.05).The HAD score of the observation group was (6.04±1.95)pionts,which was lower than (8.76±1.21)points of the control group.CCB score of the observation group was (49.82±7.61)points,which was higher than (45.33±6.90)points of the control group,the differences were statistically significant (t=10.15,11.32,all P＜0.05).ConclusionTaking the free position with duole tools during maternal first labor stage can improve the natural delivery rate,tolerate pain and postpartum response ability significantly,the first labor stage significantly shortened,postpartum adverse reactions and psychological anxiety decreased.