床旁超声监测胃残余量指导危重症患者早期肠内营养的应用效果  

Application Effect of Bedside Ultrasound Monitoring Gastric Residue to Guide Early Enteral Nutrition in Critically Ill Patients

作　　者：熊芳婷 胡敏[1] 凌颜 姚莹 毛珍珠 XIONG Fangting;HU Min;LING Yan;YAO Ying;MAO Zhenzhu(Department of Neurology,the Second Affiliated Hospital of Nanchang University,Nanchang Jiangxi 330000,China)

机构地区：[1]南昌大学第二附属医院神经内科,江西南昌330000

出　　处：《中国卫生标准管理》2023年第16期72-76,共5页China Health Standard Management

摘　　要：目的分析床旁超声监测胃残余量对于指导危重患者早期肠内营养实施的临床应用效果。方法采取便利抽样法择取江西省某三级甲等医院神经内科2022年8月—2023年4月治疗的行肠内营养支持的60例危重患者,随机分为对照组(常规肠内营养支持,30例)、观察组(床旁超声监测胃残余量指导下实施早期肠内营养,30例),分析其临床应用效果。结果其中对照组、观察组分别退出1例、2例,观察组干预后胃内容反流、误吸、中断肠内营养等总发生率低于对照组,差异有统计学意义(P<0.05),肠内营养达标时间、ICU停留时间、调整肠内营养时间均短于对照组,差异有统计学意义(P<0.05);观察组干预后焦虑评分、抑郁评分均低于对照组,差异有统计学意义(P<0.05)。结论床旁超声监测胃残余量指导危重患者早期肠内营养实施,能够降低胃内容物反流、误吸等不良情况的发生率,缩短肠内营养达标时间、调整肠内营养时间,改善患者心理情况,有利于改善预后,值得推荐。Objective To study and analyze the clinical application effect of bedside ultrasound monitoring of gastric residue in guiding early enteral nutrition implementation in critically ill patients.Methods A convenient sampling method was used to select 60 critically ill patients who received enteral nutrition support from the department of neurology at grade A tertiary hospital in Jiangxi Province from August 2022 to April 2023.They were randomly divided into a control group(30 cases with routine enteral nutrition support)and an observation group(30 cases with early enteral nutrition guided by bedside ultrasound monitoring of gastric residual volume)to study and analyze their clinical application effects.Results The control group and observation group withdrew 1 case and 2 cases respectively.The total incidence of gastric reflux,aspiration,and interruption of enteral nutrition in the observation group after intervention,the difference was statistically significant(P<0.05),as well as enteral nutrition standard time,ICU stay time and adjusted enteral nutrition time were shorter than control group,the difference was statistically significant(P<0.05).After intervention,the anxiety and depression scores of the observation group were lower than those of the control group,the difference was statistically significant(P<0.05).Conclusion Bedside ultrasound monitoring of gastric residue can guide the implementation of early enteral nutrition in critically ill patients,reduce the probability of adverse situations such as aspiration,improve patients'psychological condition,shorten the time for enteral nutrition to meet standards,adjust enteral nutrition time,and improve prognosis.It is worth recommending.

关 键 词：床旁超声监测 胃残余量 危重患者 早期肠内营养 目标喂养量 ICU停留时间 

分 类 号：R459[医药卫生—治疗学]