通过床旁超声早期诊断重症患者肠道的临床研究  

Clinical study of early diagnosis of intestinal tract in critically ill patients by bedside ultrasound

作　　者：何佩娟[1] 李贡文[2] 曾迎春[1] 莫蓓 HE Peijuan;LI Gongwen;ZENG Yingchun;MO Bei(Department of Critical Care Medicine,Jiangxi Provincial Chest Hospital,Jiangxi Province,Nanchang 330006,China;Department of Internal Medicine,Jiangxi Provincial Chest Hospital,Jiangxi Province,Nanchang 330006,China;Department of Anesthesiology,Affiliated Hospital of Jiangxi University of Traditional Chinese Medicine,Jiangxi Province,Nanchang 330006,China)

机构地区：[1]江西省胸科医院重症医学科,江西南昌330006 [2]江西省胸科医院内科,江西南昌330006 [3]江西省中医药大学附属医院麻醉科,江西南昌330006

出　　处：《中国当代医药》2022年第32期37-40,共4页China Modern Medicine

基　　金：江西省卫生健康委科技计划项目(202130970)。

摘　　要：目的探讨通过床旁超声早期诊断重症患者肠道的临床价值。方法选择2021年1月至10月江西省胸科医院重症监护室收治的50例非消化道疾病患者作为研究对象,按照随机数字表法分为观察组和对照组,每组各25名。观察组行床旁超声检查,对照组以临床症状为标准进行诊断,比较两组患者肠管直径、肠壁厚度及肠蠕动指标,比较两组患者急性胃肠损伤概念(AGI)Ⅲ级发生率及28 d死亡率,统计两组患者重症监护室(ICU)住院时间及肠道功能恢复时间(喂养耐受)情况。结果观察组肠管直径评分低于对照组,肠壁厚度评分低于对照组,肠蠕动评分低于对照组,差异有统计学意义(P<0.05)。观察组AGIⅢ级发生率和28 d死亡率均低于对照组,差异有统计学意义(P<0.05),观察组ICU住院时间及肠道功能恢复时间(喂养耐受)均短于对照组,差异有统计学意义(P<0.05)。结论针对ICU入组患者,实施床旁超声检查,能早期了解患者胃肠道功能,降低AGIⅢ级发生率,降低死亡率,缩短住院时间,并对促进患者胃肠道功能早期恢复有重要价值。Objective To explore the clinical value of early diagnosis of intestinal tract in critically ill patients by bedside ultrasonography.Methods Fifty patients with non-digestive tract diseases admitted to the intensive care unit of Jiangxi Provincial Chest Hospital from January to October 2021 were selected as the research objects.According to the random number table method,they were divided into observation group and control group,with 25 cases in each group.The observation group underwent bedside ultrasonography,and the control group was diagnosed based on clinical symptoms.The bowel diameter,bowel wall thickness and bowel motility indexes were compared in the observation group.The incidence rate of acute gastrointestinal injury concept(AGI)gradeⅢand 28-day mortality were compared between the two groups,and the hospital stay in the intensive care unit(ICU)and the recovery time of intestinal function(feeding tolerance)were compared between the two groups.Results The intestinal diameter score of the observation group was lower than that of the control group,the intestinal wall thickness score was lower than that of the control group,the inestinal peristalsis score was lower than that of the control group,and the differences were statistically significant(P<0.05).The incidence of AGI gradeⅢand 28-day mortality in the observation group were lower than those in the control group,the differences were statistically significant(P<0.05).The ICU stay time and intestinal function recovery time(feeding tolerance)of the observation group were shorter than those of the control group,and the differences were statistically significant(P<0.05).Conclusion For patients admitted to ICU,bedside ultrasonography can early understand the gastrointestinal function of patients,reduce the incidence of AGI gradeⅢ,reduce the mortality rate,shorten the length of hospital stay,and is of great value in promoting the early recovery of gastrointestinal function of patients.

关 键 词：床旁超声 早期诊断 重症患者 肠道功能 

分 类 号：R445.1[医药卫生—影像医学与核医学]