持续腹内压监测联合前馈控制理论在机械通气患者早期肠内营养耐受性评估中的临床应用  

Clinical application of continuous intra-abdominal pressure monitoring combined with feedforward control theory in early enteral nutrition tolerance assessment in patients with mechanical ventilation

作　　者：曾丽云[1] 罗春霞[1] 邓祥 ZENG Liyun;LUO Chunxia;DENG Xiang(Department of Respiratory and Critical Care Medicine,Sanming Second Hospital,Fujian,Sanming 366000,China)

机构地区：[1]福建省三明市第二医院呼吸与危重症医学科,福建三明366000

出　　处：《中国医药科学》2024年第20期148-151,194,共5页China Medicine And Pharmacy

基　　金：福建中医药大学校管课题临床专项(XB2023084)。

摘　　要：目的 通过随机试验设计,探究持续腹内压监测联合前馈控制理论在提升机械通气患者早期肠内营养耐受性方面的效果。方法 本研究共纳入2022年6月至2023年6月在三明市第二医院就诊的机械通气患者100例,将机械通气患者随机分为两组,每组各50例,对照组采用常规肠内营养支持,试验组则在此基础上引入持续腹内压监测与前馈控制理论。观察两组患者的机械通气时间与住院时间、干预后第1、3、7、14天的腹内压变化情况、营养状态指标、营养风险筛查2002(NRS2002)评分以及肠内营养的耐受性情况。结果 试验组机械通气时间和住院时间均显著短于对照组,差异有统计学意义(P <0.05)。干预后第7、14天,试验组腹内压显著低于对照组,差异有统计学意义(P <0.05)。干预后第14天,试验组血清前白蛋白、血清白蛋白以及血红蛋白水平均显著高于对照组,差异有统计学意义(P <0.05)。干预后第14天,试验组NRS2002评分显著低于对照组,差异有统计学意义(P <0.05)。试验组良好耐受比例显著高于对照组,而中等耐受和不耐受比例均显著低于对照组,差异有统计学意义(P <0.05)。结论 结合持续的腹内压监测和前馈控制理论,可以显著提高机械通气患者在早期对肠内营养的耐受性,优化患者营养状态并减少营养缺乏的风险,这种方法在临床实践中具有广泛的应用价值。Objective To explore the effect of continuous intra-abdominal pressure monitoring combined with feedforward control theory in improving early enteral nutrition tolerance in patients with mechanical ventilation through randomized trial design.Methods A total of 100 patients with mechanical ventilation who visited the Sanming Second Hospital from June 2022 to June 2023 were included in this study.The patients with mechanical ventilation were randomly divided into two groups,with 50 cases in each group.The control group received routine enteral nutrition support,while the experimental group received continuous abdominal pressure monitoring and feedforward control theory on this basis.Observe the duration of mechanical ventilation and hospitalization,changes in intra-abdominal pressure on days 1,3,7,and 14 after intervention,nutritional status indicators,nutrition risk screening 2002(NRS2002)score,and tolerance to enteral nutrition in two groups of patients.Results The mechanical ventilation time and hospitalization time of the experimental group were significantly shorter than those of the control group,and the difference was statistically significant(P<0.05).On the 7th and 14th day after intervention,the intra-abdominal pressure in the experimental group was significantly lower than that in the control group,and the difference was statistically significant(P<0.05).On the 14th day after intervention,the levels of serum prealbumin,serum albumin,and hemoglobin in the experimental group were significantly higher than those in the control group,and the differences were statistically significant(P<0.05).On the 14th day after intervention,the NRS2002 score of the experimental group was significantly lower than that of the control group,and the difference was statistically significant(P<0.05).The proportion of good tolerance in the experimental group was significantly higher than that in the control group,while the proportion of moderate tolerance and intolerance was significantly lower than that in the control group,and t

关 键 词：腹内压监测 前馈控制理论 早期肠内营养耐受 机械通气 

分 类 号：R459.3[医药卫生—治疗学]