床旁超声监测胃残余量对急诊科老年脓毒症患者的喂养效果评价  

Evaluation of Feeding Effect of Bedside Ultrasound Monitoring Gastric Residual Volume in Elderly Patients with Sepsis in Emergency Department

作　　者：梁潇[1] 孙雪莲[1] 邢正涛 赵学梅 程萌 Liang Xiao;Sun Xuelian;Xing Zhengtao;Zhao Xuemei;Cheng Meng(Xuanwu Hospital,Capital Medical University,100053;不详)

机构地区：[1]首都医科大学宣武医院,北京市100053

出　　处：《中国病案》2023年第1期83-85,共3页Chinese Medical Record

基　　金：首都医科大学宣武医院护理专项课题(XWHL-2018004);国家自然科学基金(81801313)。

摘　　要：目的 探索床旁超声评估胃残余对改善急诊科老年脓毒症患者喂养耐受性及营养效果的应用评价。方法 纳入2020年1月1日-2020年12月31日间收入急诊科的60例持续肠内营养老年脓毒症患者,按入院时间分为对照组和试验组各30例,试验组应用床旁超声监测胃残余量,比较7天内发生返流、误吸、腹泻、喂养不耐受、营养指标、目标热量达标率及护理操作时长的改善情况。结果 试验组与对照组患者接受肠内营养后7天内的胃残余量差异无统计学意义(P>0.05);在营养指标方面,试验组喂养7天时的血清白蛋白水平[(49.87±3.52)g/L]较对照组[(47.73±4.59)g/L]高,差异有统计学意义(t=2.021,P<0.05);试验组发生返流、腹泻、EN中断的喂养不耐受情况显著减少(P<0.05);试验组护理操作时间[(68.65±4.77)s]较对照组[(73.11±4.35)s]减少;试验组较对照组提前75.33小时实现患者平均当日目标热量达标。结论 应用床旁超声的方法监测老年脓毒症患者的胃残余量有助于提高患者营养支持效果,降低喂养不耐受发生率的同时减少护理工作负荷。Objectives This study aims to explore the application of bedside ultrasound monitoring gastric residual volume in elderly patients with sepsis in the emergency department.Methods A total of 60 elderly patients with sepsis with continuous enteral nutrition who were admitted to the emergency department from January 1, 2020to December 31, 2020 were included in this study. They were divided into a control group and an experimental group according to the time of admission, with 30 cases in each group.In the experimental group, bedside ultrasonography to was used to monitor gastric residual volume.The improvement of reflux, aspiration, diarrhea,feeding intolerance, nutritional indicators, target calorie compliance rate, and nursing operation time within 7 days were compared.Results There was no significant difference in gastric residual volume between the experimental group and the control group within 7 days(P>0.05). In terms of nutritional indexes, the level of serum albumin [(49.87±3.52)g/l] in the experimental group was higher than that in the control group [(47.73±4.59)g/l] at 7days of feeding, and the difference was statistically significant(t=2.021,P<0.05). The feeding intolerance of reflux, diarrhea, and interruption in the experimental group decreased significantly(P<0.05). The nursing operation time [(68.65±4.77)s] in the experimental group was lower than that in the control group [(73.11±4.35)s].Compared with the control group, the experimental group achieved the average daily target calorie target of the patients 75.33 hours earlier.Conclusions Monitoring gastric residual in elderly patients with sepsis by bedside ultrasound has guiding significance for improving clinical feeding tolerance, promoting feeding effect, and reducing nursing workload.

关 键 词：床旁超声 GRV 喂养不耐受 

分 类 号：R459.7[医药卫生—急诊医学]