超声监测胃残余量对危重症患者肠内营养的疗效观察  

Effect of ultrasound monitoring of gastric residual volume on enteral nutrition in critically ill patients

作　　者：钟莉[1] 陆文明[1] 董朝晖[1] 唐坎凯[1] 杨卿[1] 徐巍[1] ZHONG Li;LU Wenming;DONG Zhaohui;TANG Kankai;YANG Qing;XU Wei(Department of Critical Care,Huzhou First People's Hospital in Zhejiang Province,Huzhou313000,China)

机构地区：[1]浙江省湖州市第一人民医院重症监护科

出　　处：《中国现代医生》2020年第1期116-120,共5页China Modern Doctor

基　　金：浙江省医药卫生科技计划项目（2019PY015）;浙江省湖州市科技局项目（2017GYB08）

摘　　要：目的 观察床旁超声监测胃残余量对危重症肠内营养患者的疗效影响。方法 选取2016年6月~2017年3月间在我院重症医学科(ICU)住院治疗持续行肠内营养的60例危重症患者,按照数字表法随机分为两组。观察组采取床旁超声监测胃残余量,每天监测2次,指导肠内营养实施;对照组采用注射器回抽法,每4小时监测胃残余量进而调整肠内营养方案。观察两组患者血红蛋白、血清前清蛋白、转铁蛋白、白蛋白等营养相关指标水平;并记录两组患者肠内营养期间出现的并发症。结果 观察组肠内营养1周后血红蛋白、血清前清蛋白、白蛋白水平分别为(118.23±11.58)g/L、(280.56±16.88)mg/L和(33.83±7.42)g/L,同时期对照组三项营养指标分别为(108.98±11.64)g/L、(274.53±15.28)mg/L和(30.57±5.62)g/L,血红蛋白和白蛋白水平差异均有统计学意义(P<0.05)。观察组出现呕吐3例、腹泻6例、胃潴留5例;对照组出现呕吐5例、腹泻9例、胃潴留9例,差异有统计学意义(P<0.05)。观察组肠内营养达到目标喂养量时间为(3.05±0.68)d,对照组为(5.02±0.65)d,差异有统计学意义;观察组ICU住院时间为(9.52±1.26)d,对照组为(11.47±1.57)d,差异有统计学意义(P<0.05)。结论 床旁超声监测胃残余量可以更科学地指导危重症患者肠内营养方案,减少肠内营养并发症,更快地达到目标喂养量,提高营养指标,缩短ICU住院时间。Objective To observe the effect of ultrasound monitoring of gastric residual volume(GRV)on enteral nutrition in critically ill patients.Methods 60 ICU patients treated in our hospital from June 2016 to March 2017 were selected and randomly divided into two groups.Patients in the observation group were given bedside ultrasound to monitor GRV,twice a day,to guide the implement of enteral nutrition.Patients in the control group were monitored by syringe retraction method every 4 hours.The levels of nutritionally relevant indicators such as hemoglobin,serum prealbumin,transferrin and albumin were observed in the two groups.The complications during enteral nutrition were recorded in the two groups.Results After 1 week of enteral nutrition in the observation group,the levels of hemoglobin,serum prealbumin and albumin were(118.23±11.58)g/L,(280.56±16.88)mg/L and(33.83±7.42)g/L,respectively.The three nutritional indicators in the control group were(108.98±11.64)g/L,(274.53±15.28)mg/L and(30.57±5.62)g/L,respectively,and the differences of hemoglobin and albumin were statistically significant(P<0.05).There were 3 cases of vomiting,6 cases of diarrhea and 5 cases of gastric retention in the observation group.There were 5 cases of vomiting,9 cases of diarrhea and 9 cases of gastric retention in the control group.The difference was statistically significant(P<0.05).The time of reaching the volume goal by enteral nutrition in the observation group was(3.05±0.68)d,and was(5.02±0.65)d in the control group.The difference was statistically significant.The ICU stay in the observation group was(9.52±1.26)d,and in the control group it was(11.47±1.57)d.The difference was statistically significant(P<0.05).Conclusion Bedside ultrasound monitoring of gastric residuals can more scientifically guide enteral nutrition in critically ill patients,reduce enteral nutrition complications,achieve target feeding volume faster,improve nutritional indicators,and shorten ICU stay.

关 键 词：危重症 肠内营养 超声检查 胃残余量 

分 类 号：R459.3[医药卫生—治疗学]