床旁超声监测胃残余量在机械通气老年脓毒症患者肠内营养中的应用  

Application of bedside ultrasound monitoring of gastric residual volume in enteral nutrition among elderly patients with sepsis undergoing mechanical ventilation

作　　者：裴永菊[1] 谢舒棠 席芳[1] 王昊 张爱兰[1] PEI Yong-ju;XIE Shu-tang;XI Fang;WANG Hao;ZHANG Ai-lan(Department of Respiratory Critical Care,Henan Provincial People′s Hospital,Zhengzhou 450000,China;School of Nursing,Henan University,Kaifeng 475000,China)

机构地区：[1]河南省人民医院呼吸重症科,郑州市450000 [2]河南大学护理学院,开封市475000

出　　处：《广西医学》2020年第14期1787-1790,共4页Guangxi Medical Journal

基　　金：国家自然科学基金(81760353)。

摘　　要：目的探讨床旁超声监测胃残余量在机械通气老年脓毒症患者肠内营养中的应用效果。方法将102例机械通气老年脓毒症患者分为超声组和对照组,每组51例。两组均行气管插管接呼吸机辅助通气,给予鼻胃管持续泵入肠内营养液。超声组应用床旁超声监测胃残余量指导肠内营养治疗,对照组应用传统注射器抽吸法评估胃残余量指导肠内营养治疗。比较两组患者肠内营养达标时间、护士操作时间、给予肠内营养治疗前后血清白蛋白水平,记录两组并发症发生情况。结果超声组肠内营养达标时间、护士操作时间短于对照组(P<0.05),给予肠内营养前后两组血清白蛋白水平差异无统计学意义(P>0.05)。两组患者的腹胀、腹泻和营养液泵入中断发生率差异无统计学意义(均P>0.05)。结论采用床边超声监测机械通气老年脓毒症患者的胃残余量,可以有效地指导肠内营养治疗方案的调整,缩短护士操作时间和患者肠内营养达标时间。Objective To explore the application effect of bedside ultrasound monitoring of gastric residual volume in enteral nutrition among elderly patients with sepsis undergoing mechanical ventilation.Methods A total of 102 elderly patients with sepsis undergoing mechanical ventilation were divided into ultrasound group and control group,with 51 cases in each group.Both groups were given endotracheal intubation and ventilator-assisted ventilation,and continuous pumping of enteral nutrient solution via nasogastric tube.In the ultrasound group,bedside ultrasound monitoring of gastric residual volume was applied to guiding enteral nutrition treatment,while in the control group,gastric residual volume assessment was performed using the method of traditional syringe aspiration for guiding enteral nutrition treatment.The standard time of enteral nutrition,operating time of nurses,and serum albumin levels before and after enteral nutrition were compared between the two groups,and the incidence of complications of the two groups was recorded.Results The standard time of enteral nutrition,and operating time of nurses in the ultrasound group were shorter than those in the control group(P<0.05),and there was no statistically significant difference between the two groups in serum albumin level before or after enteral nutrition(P>0.05).No statistically significant difference was found between the two groups in incidence rate of abdominal distension,diarrhea,or enteral nutrition pumping interruption(all P>0.05).Conclusion For elderly patients with sepsis undergoing mechanical ventilation,applying bedside ultrasound to monitoring gastric residual volume can effectively guide the adjustment of enteral nutrition treatment regimen and reduce nurses′operation time and patients′standard time of enteral nutrition.

关 键 词：脓毒症 机械通气 肠内营养 胃残余量 床旁超声 老年人 

分 类 号：R631.2[医药卫生—外科学]