胃肠电图评价ICU内肠内营养患者胃肠动力水平的临床价值  

Evaluation of gastrointestinal motility level in patients with enteral nutrition in ICU by gastrointestinal electrical mapping

作　　者：罗莉 郑伟 张悦萌 LUO Li;ZHENG Wei;ZHANG Yue-meng(FAW General Hospital,Changchun 130011,China)

机构地区：[1]吉林省一汽总医院,吉林长春130011

出　　处：《中国实验诊断学》2020年第3期402-405,共4页Chinese Journal of Laboratory Diagnosis

摘　　要：目的探讨胃肠电图对ICU肠内营养(EN)患者胃肠动力水平评价中的临床价值。方法对92例入住ICU进行肠内营养的危重病人及28例健康体检者进行胃肠电图、胃肠激素水平的检测,比较肠内营养前后的变化,并分析各参数与危重病评分(APACHEⅡ)、GCS评分、主要疾病诊断、机械通气、胃肠耐受情况的相互关系。结果观察组餐前和餐后胃肠电节律紊乱高于对照组(P<0.01),观察组餐前的正常慢波百分比低于对照组(P<0.01),观察组胆囊收缩素(CCK)和血管活性肠肽(VIP)水平高于对照组(P<0.05);APACHEⅡ<20分组(B组)的VIP水平显著低于APACHEⅡ≥20分组(A组)(P<0.05),两组的幅值、主频、胃肠电节律紊乱、正常慢波百分比、餐前/餐后功率比、胃动素(MTL)、CCK、EN耐受性无显著差异。结论胃肠电图中的胃肠电节律紊乱升高及餐前的正常慢波百分比降低与胃肠激素CCK、VIP提示的胃肠功能障碍是一致的,可以应用胃肠电图评估ICU患者肠内营养,指导肠内营养的个体化实施。Objective To evaluate the clinical value of gastrointestinal power in the evaluation of gastrointestinal motility level in patients with enteral nutrition in ICU.Methods 92 cases of critically ill patients with enteral nutrition in ICU and 28 patients with health examination were tested in gastrointestinal and gastrointestinal hormones,compared with the changes before and after Enteral nutrition,and analyzed the correlation between parameters and critical illness score(Apacheⅱ),GCS score,main disease diagnosis,mechanical ventilation and gastrointestinal tolerance.Results In the observation group,the gastrointestinal electrical rhythm disorder was higher than that in the control group(P<0.01),the normal slow wave percentage before meal was lower than that in the control group(P<0.01),the observation group CCK and VIP level were higher than the control group(P<0.05);The VIP level of APACHEⅡ <20 Group(Group B)was significantly lower than that of APACHEⅡ≥20 Group(agroup)(P<0.05),the amplitude of the two groups,the main frequency,gastrointestinal rhythm disorder,the normal slow wave percentage,pre/post meal power ratio,MTL,CCK,EN tolerance was not significantly different.Conclusion The disturbance of gastrointestinal electric rhythm and the decrease of normal slow wave percentage in gastrointestinal electric chart is consistent with gastrointestinal hormone CCK and VIP tip,and can be used to evaluate the feasibility of enteral nutrition in ICU patients,and to guide the individualized implementation of enteral nutrition.

关 键 词：胃肠电图 肠内营养 胃肠动力 ICU 

分 类 号：R444[医药卫生—诊断学]