床边超声监测胃残余量在重症患者早期肠内营养管理中的应用研究  

Research on application of bedside ultrasound monitoring gastric residual amount on early management of enteral nutrition for severe patients

作　　者：徐东平[1] 钱正仙[1] 全殷殷 谢邦好 陈肖敏[1] Xu Dongping;Qian Zhengxian;Quan Yinyin;Xie Banghao;Chen Xiaomin(Zhejiang Provincial People’s Hospital(People’s Hospital of Hangzhou Medical College),Hangzhou Zhejiang 310014,China)

机构地区：[1]浙江省人民医院(杭州医学院附属人民医院),浙江杭州310014

出　　处：《护理与康复》2021年第3期7-11,共5页Journal of Nursing and Rehabilitation

基　　金：浙江省医药卫生科技计划项目,编号2019KY318。

摘　　要：目的观察床边超声监测胃残余量在重症患者早期肠内营养管理中的应用效果。方法将120例患者按随机数字表分为对照组和观察组各60例。对照组患者采用回抽胃液法监测胃残余量,观察组患者采用床边超声监测胃残余量。比较两组患者的肠内营养达标情况、营养状况、喂养不耐受情况。结果肠内营养第5天,观察组肠内营养达标率为70.0%,高于对照组的51.7%;肠内营养第7天,观察组肠内营养达标率为96.7%,高于对照组的81.7%,差异均有统计学意义(P<0.05)。入院14 d时,观察组前白蛋白、血清白蛋白、肱三头肌皮皱厚度和上臂肌围分别为(216.4±16.4)g/L、(37.5±5.3)g/L、(9.4±0.7)mm和(20.6±0.7)cm,高于对照组患者的(183.5±12.5)g/L、(32.8±4.2)g/L、(8.4±0.8)mm和(19.0±0.5)cm,差异均有统计学意义(P<0.05)。观察组呕吐、腹胀、腹泻、腹腔高压发生率均低于对照组,差异有统计学意义(P<0.05);对照组发生4例腹腔间隔室综合征,观察组未发生。结论在重症患者早期肠内营养管理中应用床边超声监测胃残余量,可提高患者肠内营养达标率,改善营养状况,减少喂养不耐受情况。Objective To observe the effect of bedside ultrasound monitoring gastric residual amount on early management of enteral nutrition for critical patients.Method Divide 120 patients into observation group(n=60)and control group(n=60)by random number table.Monitor gastric residual amount of patients in control group by withdrawing gastric fluid and monitor gastric residual amount of patients in observation group by bedside ultrasound monitoring.Compare the standard-reaching of enteral nutrition,nutritional status and feeding intolerance between two groups.Result The standard-reaching rate of enteral nutrition is 70.0%in observation group,which is higher than 51.7%in control group in the fifth day of enteral nutrition.The standard-reaching rate of enteral nutrition is 96.7%in observation group,which is higher than 81.7%in control group in the seventh day of enteral nutrition.The difference is significant(P<0.05).Prealbumin,serum albumin,triceps skinfold thickness and arm muscle circumference are(216.4±16.4)g/L,(37.5±5.3)g/L,(9.4±0.7)mm and(20.6±0.7)cm in observation group,which is higher than(183.5±12.5)g/L,(32.8±4.2)g/L,(8.4±0.8)mm and(19.0±0.5)cm in control group in the 14th day of admission.The difference is significant(P<0.05).Incidence of vomiting,abdominal distension,diarrhea and abdominal hypertension are all lower in observation group than in control group,the difference is significant(P<0.05).There are four cases of abdominal compartment syndrome in control group and non in observation group.Conclusion Bedside ultrasound monitoring gastric residual amount applied in early management of enteral nutrition for critical patients can improve the standard-reaching rate of enteral nutrition,improve nutritional status and relieve feeding intolerance.

关 键 词：肠内营养 喂养不耐受 胃残余量 床边超声 营养管理 

分 类 号：R459.3[医药卫生—治疗学]