胃肠超声在重型颅脑损伤病人营养治疗中的应用价值  

The application of gastrointestinal ultrasound in nutritional management of patients with severe craniocerebral injury

作　　者：何聪[1] 付优[1] 白银箱 赵鹤龄[1] 申丽旻[1] 杜全胜[1] 王显雷[2] HE Cong;FU You;BAI Yin-xiang;ZHAO He-ling;SHEN Li-min;DU Quan-sheng;WANG Xian-lei(Department of ICU,Hebei General Hospital,Shijiazhuang 050051,Hebei,China;Department of Tuberculosis 3rd Inpatient Area,Hebei Chest Hospital,Shijiazhuang 050048,Hebei,China)

机构地区：[1]河北省人民医院重症医学科,河北石家庄050051 [2]河北省胸科医院结核三病区,河北石家庄050048

出　　处：《肠外与肠内营养》2022年第1期24-27,34,共5页Parenteral & Enteral Nutrition

基　　金：河北省卫生健康委员会科技计划项目(20200741)。

摘　　要：目的:探讨床旁胃肠超声在重型颅脑损伤病人中的应用价值。方法:选择2019年8月至2021年8月入住河北省人民医院重症医学科的重型颅脑损伤病人56例,随机分为2组,对照组和干预组各28例,干预组病人全部应用超声进行胃窦运动指数、胃窦横截面积监测,并联合应用肠道超声指导肠内营养的应用。对照组病人根据胃残余量经验性调整肠内营养的速度。结果:干预组肠内营养开始时间及达到目标喂养量时间均短于对照组,差异有统计学意义(P<0.05);观察组返流发生率低于对照组,差异有统计学意义(P<0.05);2组误吸、腹泻及营养中断率、住ICU时间及28 d病死率比较差异无统计学意义(P>0.05)。结论:胃肠超声可为重型颅脑外伤病人提供个体化的营养治疗方案,尽早达到目标喂养量,并可减少返流发生率。Objective:To explore the application of bedside gastrointestinal ultrasound in patients with severe craniocerebral injury.Methods:Fifty-six patients with severe craniocerebral injury were randomly divided into two groups,namely the control group and the intervention group,with 28 cases in each group.All patients Ultrasound was used in the intervention group to calculate the gastric antrum movement index and cross-sectional area,and to guide the application of enteral nutrition.The rate of enteral nutrition was empirically adjusted according to the gastric residual volume in the control group.Results:The initiation of enteral nutrition and the time to reach the feeding target in the intervention group were shorter than those in the control group,with statistical significance(P<0.05).The incidence of reflux in intervention group was remarkably lower than that in control group(P<0.05).There was no significant difference in the rates of aspiration,diarrhea,nutritional interruption,as well as the length of ICU stay and 28-day mortality between the two groups(P>0.05).Conclusion:Gastrointestinal ultrasound could provide individualized nutritional management for patients with severe craniocerebral injury,achieve the feeding target in shorter time,and reduce the incidence of reflux.

关 键 词：胃肠超声 重型颅脑损伤 胃窦动力监测 胃窦运动指数 

分 类 号：R651.15[医药卫生—外科学] R445.1[医药卫生—临床医学]