B超检测胃动力指导危重症病人肠内营养的应用  

Enteral feeding guided by gastric motility measurement with B-ultrasonography in critical illness

作　　者：张荣丽[1] 何伟[1] 李彤[1] 侯静[1] 周华[1] 许媛[1] 

机构地区：[1]首都医科大学附属北京同仁医院ICU,北京100730

出　　处：《肠外与肠内营养》2011年第6期341-343,347,共4页Parenteral & Enteral Nutrition

摘　　要：目的:探讨改良B超胃窦单切面法检测胃窦运动指数(MI)在危重症病人早期肠内营养(EEN)中的作用。方法:将62例拟行经鼻胃管喂养的病人随机分为研究组和对照组,每组31例。研究组病人每天应用B超行胃窦单切面法测定空腹MI,以确定当天EN计划;对照组则由主管医师根据自己的经验制订。EN期间,根据病人胃残余量和耐受性调整EN的速度,比较两组病人的一般情况、EN实施情况和相关终点指标。结果:研究组病人EN起始速度明显高于对照组(40～75 ml/h vs 30～50 ml/h,P=0.04);达到最大喂养速度的时间也有下降趋势(4.0 h vs 9.3 h);研究组病人超过一种以上EN并发症的发生率(37.9%)明显低于对照组(62.1%),两组的终点指标无明显差异。结论:应用改良B超胃窦单切面法测定MI可以较客观地确定EN喂养速度,有助于及早实现喂养目标和降低EN相关的并发症。Objective： To investigate the effect of MI（movement index,MI） measured by modified single transverse section of gastric antrum measurement using ultrasonography in early enteral nutrition of critically ill patients.Methods： 62 Patients who planed to be fed through a nasogastric tube,were divided into two groups randomly：MI group（n=31） and control group（n=31）.MI was measured before gastric feeding by ultrasonography everyday in MI group,and the feeding rate were guided by MI.Enteral feeding rate was decided by physicians according to their personal experience in the control.The general state of health,the practice of the enteral nutrition and the outcomes were compared.Results： MI guiding enteral feeding could achieve higher initial speed（P = 0.04）,which was 40-75 ml/h in MI group vs.30-50 ml/h in the control group.Besides,the time to reach the maximum feeding rate was reduced than that in the control（4.0 vs 9.3 h）.One or more complications which related with enteral nutrition was occured in 37.9% patients in MI group,whereas it was 62% in the control.There were no significant differences in patients outcomes between the two groups.Conclusion： The gastric antrum motility measurement with ultrasonography in method of modified single transverse section can be used as an objective indicator on evaluation early enteral feeding in critically ill patients,which is helpful is improving enteral feeding and reducing related complications.

关 键 词：危重症 早期肠内营养 B超 胃肠动力 胃窦运动指数 

分 类 号：R459.3[医药卫生—治疗学] R445.1[医药卫生—临床医学]