ICU老年危重患者肠内营养耐受性及胃残余量监测的调查研究  

Current status of enterai nutrition tolerance and gastric residual volume monitoring in elderly critically ill patients in ICU

作　　者：韩媛媛[1] 邵欣[1] 常志刚[1] 刘芳[3] 关欣[2] Han Yuanyuan;Shao Xin;Chang Zhigang;Liu Fang;Guan Xin(ICU,Beijing Hospital,National Center of Gerontology,Beijing 100730,China;Neurological ICU,Xuanwu Hospital,Capital Medical University,Beifing 100053,Chin;The Second Inpatient Department,Beijing Hospital,National Center of Gerontology,Beijing 100730,China)

机构地区：[1]北京医院ICU国家老年医学中心,100730 [2]北京医院ICU第二住院部管理处,100730 [3]首都医科大学宣武医院神经内科ICU,北京100053

出　　处：《中华现代护理杂志》2018年第28期3353-3356,共4页Chinese Journal of Modern Nursing

摘　　要：目的调查全国范围ICU老年危重患者胃残余量（GRV）和肠内营养（EN）耐受性监测的现状，为寻找老年危重患者最佳EN耐受性评估方法并规范其操作流程提供依据。方法采用便利抽样法，选取全国22个省、5个自治区及4个直辖市的724个ICU进行老年危重患者EN策略管理、EN管路维护、EN耐受性评估及GRV监测相关内容的问卷调查。结果全国724个ICU在老年危重患者实施EN期间实施常规GRV监测的有461个（63．7％），使用EN耐受性评分工具的有166个（22．9％），开展B超监测GRV的有156个（21．5％），不同类型ICU在EN耐受性评分工具的使用及开展B超监测GRV方面差异无统计学意义（P〉0．05）。常规监测GRV的科室呕吐和显性误吸发生率均低于非常规监测科室，差异有统计学意义（P〈0．05）。结论ICU老年危重患者实施EN期间应每日评估EN耐受性，建议实施常规可行的GRV监测。Objective To investigate the current status of monitoring gastric residual volume （GRV） and enteral nutrition （EN） tolerance in critically ill elderly patients in ICU nationwide, so as to provide evidence for finding the best assessment method of EN tolerance in critically ill elderly patients and standardizing the operation procedure. Methods A total of 724 ICU critically ill elderly patients from 22 provinces, 5 autonomous regions and 4 municipalities were selected by convenience sampling method and investigated for EN strategy management, EN pipeline maintenance, EN tolerance assessment and GRV monitoring. Results During the period of enteral nutrition in critically ill elderly patients, 461 （63.7%） of the 724 ICUs surveyed performed routine GRV monitoring, 166 （22.9%） used the EN tolerance scoring too, 156 （21.5%） used ultrasound to monitor gastric residual volume. There was no statistical difference in use of EN tolerance score tool and B-mode ultrasound monitoring among different types of ICU （P〉0.05）. The incidence of vomiting and dominant aspiration in routine monitoring departments was lower than that in unconventional monitoring departments, and the difference was statistically significant （P〈0.05）. Conclusions The elderly critically ill patients should be evaluated EN tolerance every day during the implementation of EN, and routine and feasible GRV monitoring should be carried out.

关 键 词：老年人 重症监护室 肠内营养耐受性 胃残余量 

分 类 号：R473[医药卫生—护理学]