ICU机械通气患者腹内压与肠内营养喂养不耐受的相关性  

Correlation between intra-abdominal pressure and enteral nutrition feeding intolerance in patients with mechanical ventilation in ICU

作　　者：朱苑霞 郑燕华 蔡艳[1] ZHU Yuanxia;ZHENG Yanhua;CAI Yan(Huangjiang Hospital,Dongguan 523750,China)

机构地区：[1]广东省东莞市黄江医院ICU,523750

出　　处：《护理实践与研究》2021年第2期175-178,共4页Nursing Practice and Research

摘　　要：目的探究ICU机械通气患者腹内压与肠内营养(EN)喂养不耐受的相关性。方法选择2019年2—12月医院ICU机械通气患者80例为研究对象,在患者EN之前与EN后测量患者腹内压,评估患者营养期间是否有肠内营养不耐受现象发生。结果80例患者的肠内营养喂养不耐受发生率为75%,其中肠鸣音消失或减弱的发生率为55%,腹泻发生率为48.8%。相关性分析结果显示,ICU机械通气患者的腹内压水平和喂养不耐受呈正相关(r=0.35,0.46;P<0.05)。ROC曲线分析腹内压基线水平具有一定判别喂养不耐受的能力[AUC区域分别为0.784(95%CI:0.676~0.893)和0.857(95%CI:0.766~0.949)],临界值分别为腹内压基线水平>9.75 mmHg;EN3d后的腹内压均值>11.25 mmHg。结论ICU机械通气患者的腹内压水平与肠内营养喂养不耐受正相关,医护人员需加强患者的腹内压监测,当腹腹内压基线水平≥9.75 mmHg与EN3天后的腹内压均值≥11.25 mmHg时,警惕EN喂养不耐受的发生,做好预防措施。Objective To explore the correlation between intra-abdominal pressure and enteral nutrition(EN)feeding intolerance in patients with mechanical ventilation in ICU.Methods To select 80 patients with mechanical ventilation in the ICU of hospital from February 2019 to December 2019 as the study objects,and measure the intra-abdominal pressure of the patients before and after the EN to assess whether the patients had enteral nutrition intolerance during the nutrition period.Results The incidence of enteral nutrition feeding intolerance in 80 patients was 75%.The incidence of bowel sounds disappeared or weakened was 55%,and the incidence of diarrhea was 48.8%.The results of correlation analysis showed that the intra-abdominal pressure level of mechanically ventilated patients in ICU was positively correlated with feeding intolerance(r=0.35,0.46;P<0.05).ROC curve analysis of the baseline level of intra-abdominal pressure had a certain ability to discriminate feeding intolerance[AUC areas are 0.784(95%CI:0.676~0.893)and 0.857(95%CI:0.766~0.949)respectively],the cutoff value was the baseline level of intra-abdominal pressure>9.75mmHg,and the mean intra-abdominal pressure after EN 3d>11.25 mmHg.Conclusion The intra-abdominal pressure level of patients with mechanical ventilation in ICU was positively correlated with enteral nutrition feeding intolerance.Medical staff should strengthen the monitoring of intra-abdominal pressure in patients.When the baseline level of intra-abdominal pressure was≥9.75 mmHg and the mean intra-abdominal pressure after EN 3 days was≥11.25 mmHg,be alert to EN feeding intolerance and take preventive measures.

关 键 词：肠内营养喂养不耐受 重症监护室 机械通气 腹内压 

分 类 号：R471[医药卫生—护理学]