腹腔压力分级管理策略应用于ICU重症患者的效果  

Effect of abdominal pressure grading management strategy applied to ICU patients

作　　者：胡广财 HU Guangcai(Department of Critical Care Medicine,Guangfeng District People's Hospital of Shangrao City,Shangrao City,Jiangxi Province,334600,China)

机构地区：[1]上饶市广丰区人民医院重症医学科,江西上饶334600

出　　处：《蛇志》2024年第4期429-432,共4页Journal of Snake

摘　　要：目的探讨腹腔压力分级管理策略应用于ICU重症患者的效果。方法选择2022年12月至2023年12月在我院ICU治疗的60例重症患者为研究对象,按照随机数表法分为对照组和观察组,每组30例。对照组给予常规肠内营养干预,观察组采用腹腔压力分级管理策略的肠内营养干预,观察两组的干预效果(ICU住院时间、腹腔压力、目标喂养量达标率)、胃肠道耐受情况[腹泻、胃潴留、肠营养中断及反流误吸情况]、营养指标[血红蛋白(HGB)、转铁蛋白(TRF)、前白蛋白(PAB)、白蛋白(ALB)水平]。结果观察组在ICU住院时间及干预第4、7天时的腹腔压力均较对照组低,目标喂养量达标率较对照组高,两组比较差异均有统计学意义(均P<0.05)。两组患者的胃肠道耐受情况比较,观察组的胃潴留、肠营养中断及反流误吸发生率均较对照组低,差异均有统计学意义(均P<0.05)。两组患者干预前的HGB、TRF、PAB、ALB水平比较,差异无统计学意义(均P>0.05);干预14 d后,观察组的HGB、TRF、PAB、ALB水平均高于对照组,差异均有统计学意义(均P<0.05)。结论在ICU重症患者中应用腹腔压力分级管理策略能提高目标喂养达标率及胃肠道耐受情况,改善腹腔压力及营养状况。Objective To explore the effect of hierarchical management of abdominal pressure in ICU patients.Methods 60 severe patients treated in ICU of our hospital from December 2022 to December 2023 were selected as study objects and divided into control group and observation group according to random number table method,with 30 cases in each group.The control group was given conventional enteral nutrition intervention,and the observation group was given enteral nutrition intervention with intraperitoneal pressure hierarchical management strategy.The intervention effects(length of ICU stay,abdominal pressure,target feeding rate),gastrointestinal tolerance[diarrhea,gastric retention,intestinal nutrition interruption and reflux aspiration],and nutritional indexes[hemoglobin(HGB),transferrin(TRF),prealbumin(PAB),albumin(ALB)levels]of the two groups were observed.Results The duration of ICU stay,abdominal pressure at 4 and 7 days of intervention in the observation group were lower than those in the control group,and the rate of reaching the target feeding amount was higher than that in the control group,the difference was statistically significant(P<0.05 for all).Compared with the gastrointestinal tolerance of the two groups,the incidence of gastric retention,intestinal nutrition interruption and reflux aspiration in the observation group was lower than that in the control group,and the differences were statistically significant(all P<0.05).There was no significant difference in HGB,TRF,PAB and ALB levels between the two groups before intervention(all P>0.05).After 14 days of intervention,the levels of HGB,TRF,PAB and ALB in the observation group were significantly higher than those in the control group,with statistical significance(all P<0.05).Conclusion The application of hierarchical management strategy of abdominal pressure in ICU patients with severe disease can improve the target feeding rate and gastrointestinal tolerance,and improve abdominal pressure and nutritional status.

关 键 词：重症患者 腹腔压力 胃肠道耐受情况 营养指标 目标喂养量达标率 

分 类 号：R459.3[医药卫生—治疗学]