超声监测胃残余量及胃窦动力在机械通气患者营养治疗中的作用  

Value of Ultrasonic Monitoring of Gastric Residual Volume and Gastric Antrum Dynamics in the Nutritional Treatment of Patients with Mechanical Ventilation

作　　者：何聪[1] 王显雷[2] 付优[1] 赵鹤龄[1] 杜全胜[1] 申丽旻[1] He Cong;Wang Xianlei;Fu You;Zhao Heling;Du Quansheng;Shen Limin(ICU,Hebei General Hospital Shijiazhuang 050051,China;Tuberculosis Third Ward Hebei Chest Hospital,Shijiazhuang 050048,China)

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

出　　处：《中国超声医学杂志》2022年第6期661-664,共4页Chinese Journal of Ultrasound in Medicine

基　　金：河北省卫生健康委员会科技计划项目(No.20200741)。

摘　　要：目的应用胃肠超声监测胃残余量及胃窦动力,探讨其在机械通气患者营养治疗中的应用价值。方法选择呼吸衰竭需行机械通气的患者98例,随机分为2组,对照组及观察组各49例,观察组应用超声每4~6 h进行一次ACF、ACA和MI及GRV监测。对照组经验性给予肠内营养,根据肠内营养耐受性评分调整肠内营养泵入速度。结果肠内营养开始时间、达到80%目标喂养量时间观察组短于对照组,差异有统计学意义(P<0.05);72 h达到80%目标喂养量比例观察组高于对照组,差异有统计学意义(P<0.05)。结论胃肠超声监测胃残余量及胃窦动力可为机械通气的呼吸衰竭患者制定个体化的营养治疗方案,有助于尽早启动肠内营养,尽快达到目标喂养量。Objective To investigate the value of gastric residual volume and gastric antrum motility monitoring by gastrointestinal ultrasound in the nutritional treatment of patients with mechanical ventilation.Methods A total of 98 patients with respiratory failure requiring mechanical ventilation were randomly divided into two groups:Control group and observation group,with 49 cases in each group.The observation group was monitored by ultrasound every 4-6 h for ACF(antral contraction frequency),ACA(antral contraction amplitude),MI(antral motility index)and GRV(gastric residual volume).The control group was given enteral nutrition empirically,and the pumping rate of enteral nutrition was adjusted according to enteral nutrition tolerance score.Results The start time of enteral nutrition and the time to reach 80%target feeding amount in the observation group were shorter than those in the control group,and the difference was statistically significant(P<0.05).The proportion of feeding quantity reaching 80%target at 72 h in observation group was higher than that in control group,and the differences were statistically significant(P<0.05).Conclusions Gastrointestinal ultrasound can provide evidence to individualize nutritional treatment for respiratory failure patients with mechanical ventilation,and help to start enteral nutrition and achieve the target feeding amount as soon as possible.

关 键 词：胃肠超声 胃残余量 胃窦动力 机械通气 营养治疗 

分 类 号：R445.1[医药卫生—影像医学与核医学] R459.3[医药卫生—诊断学]