艾灸联合超声监测胃残余量在脑卒中患者幽门前喂养中的应用  

Application study of upper abdominal moxibustion combined with bedside ultrasound monitoring of gastric residual volume in pre-pyloric feeding of stroke patients

作　　者：薛彬 盖美华 曹黎鸣 叶瑞忠[1] 余艳梅[1] 富燕萍[1] 章微微[1] XUE Bin;GAI Meihua;CAO Liming;YE Ruizhong;YU Yanmei;FU Yanping;ZHANG Weiwei(Department of Rehabilitation Medicine,Zhejiang Provincial People’s Hospital,Affiliated People’s Hospital of Hangzhou Medical College,Hangzhou 310014,Zhejiang,China)

机构地区：[1]浙江省人民医院(杭州医学院附属人民医院)康复医学科,浙江杭州3100141

出　　处：《中国现代医生》2024年第32期7-10,15,共5页China Modern Doctor

基　　金：浙江省卫生健康科技计划项目(2022ZH026)。

摘　　要：目的探讨上腹部艾灸联合床旁超声监测胃残余量(gastric residual volume,GRV)在脑卒中患者幽门前喂养中的应用效果。方法选取浙江省人民医院(附属人民医院)康复医学科自2023年1月1日至12月31日收治的80例脑卒中患者为研究对象,按照随机数字表法分为对照组(n=38)和观察组(n=42)。所有患者均留置鼻胃管进行幽门前喂养,对照组患者采用传统的注射器回抽法监测GRV,观察组患者采用上腹部艾灸联合床边超声监测GRV。比较两组患者的肠内营养不耐受情况、喂养并发症、入院7d肠内营养达标率、肠内营养达标时间和喂养14d前后的血红蛋白(hemoglobin,Hb)、血清前白蛋白、血清白蛋白(serum albumin,ALB)和血清转铁蛋白差异。结果与对照组比较,观察组患者呕吐、腹胀、腹内高压、返流和吸入性肺炎发生率均明显降低(P<0.05)。观察组患者入院7d肠内营养达标率明显高于对照组,肠内营养达标时间短于对照组患者,且观察组患者喂养14d后的Hb和ALB均高于对照组,差异均有统计学意义(P<0.05)。结论上腹部艾灸联合床旁超声监测GRV可明显减少脑卒中患者幽门前喂养过程中肠内营养不耐受及喂养并发症,缩短肠内营养达标时间,改善患者营养状况。Objective To explore the application effect of upper abdominal moxibustion combined with bedside ultrasound monitoring of gastric residual volume(GRV)in pre-pyloric feeding in stroke patients.Methods Eighty stroke patients admitted to the Department of Rehabilitation Medicine of Zhejiang Provincial People’s Hospital from January 1,to December 31,2023 were selected as the study subjects.They were divided into control group(n=38)and observation group(n=42)using a random number table method.All patients had a nasogastric tube for pre-pyloric feeding.The control group used the traditional syringe aspiration method to monitor GRV,while the observation group used upper abdominal moxibustion combined with bedside ultrasound to monitor GRV.The study compared the differences between two groups in terms of enteral nutrition intolerance,feeding complications,enteral nutrition compliance rate within 7 days of admission,time to achieve enteral nutrition compliance,and changes in hemoglobin(Hb),serum prealbumin,serum albumin(ALB),and serum transferrin before and after 14 days of feeding.Results The incidence rates of vomiting,abdominal distention,intra-abdominal hypertension,reflux,and aspiration pneumonia in observation group were lower than those in control group(P<0.05).The rate of achieving intestinal nutrition standard within 7 days of hospitalization was significantly higher in observation group compared to the control group.The time to achieve intestinal nutrition standard was shorter in observation group compared to control group.Furthermore,after 14 days of feeding,the levels of Hb and ALB in observation group were higher than those in control group,and the differences were statistically significant(P<0.05).Conclusion Upper abdominal moxibustion combined with bedside ultrasonic monitoring of GRV can significantly reduce intestinal nutrition intolerance and feeding complications during pre-pyloric feeding in stroke patients,shorten the time to achieve nutritional benchmarks,and improve nutritional status.

关 键 词：脑卒中 胃残余量 幽门前喂养 肠内营养 

分 类 号：R472[医药卫生—护理学]