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床旁超声在神经外科重症肠内营养支持患者胃残余量测量中的应用

[Application of bedside ultrasound in measuring gastric residual volume in neurosurgical critical patients with enteral nutrition support].

作者信息

Cao L, Ye X H, Li J, Zhang L N, Li L, Zhang W Y, Deng L L

机构信息

Intensive Care Unit, Xiangya Hospital, Central South University, Hunan Changsha 410008, China.

出版信息

Zhonghua Yi Xue Za Zhi. 2017 Mar 7;97(9):675-678. doi: 10.3760/cma.j.issn.0376-2491.2017.09.008.

Abstract

To explore the effect of bedside ultrasound in measuring gastric residual volume in neurosurgical critical patients with enteral nutrition support. From March to August 2016, 70 critically neurological patients with continues enteral nutrition who admitted in Intensive Care Unit (ICU) were randomized into two groups. The observation group applied the bedside ultrasound monitoring gastric residual volume every day to guide the implementation of enteral nutrition. The control group used syringes withdrawing every 8 hours to measure the gastric residual volume. There was no statistically significant difference in the incidence of complications include regurgitation and aspiration in this two group patients (=0.356; =1.000), while the times of interrupting enteral nutrition was lower in the observation group(25.7% vs 5.7%, 74.3% vs 94.3%, =0.045), the length of target feeding time and the length of ICU stay, the operation time was shortened, with a statistically significant difference[(2.37±0.69) d vs (3.49±0.74) d, =0.028; (8.52±5.45) d vs (6.40±2.71) d, =0.022; (58.29±11.22)s vs (67.60±7.05) s, =0.000]. The application of bedside ultrasound to measure gastric residual volume can be a scientific method to guide enteral nutrition in neurosurgical critical patients, which can reduce the times of interrupting enteral nutrition and shorten the length of target feeding time and ICU length of stay, reduce the workload of nurses.

摘要

探讨床旁超声在神经外科重症患者肠内营养支持中测量胃残余量的效果。2016年3月至8月,将70例入住重症监护病房(ICU)并接受持续肠内营养的重症神经科患者随机分为两组。观察组每天应用床旁超声监测胃残余量以指导肠内营养的实施。对照组每8小时使用注射器抽吸测量胃残余量。两组患者反流和误吸等并发症发生率差异无统计学意义(=0.356;=1.000),而观察组肠内营养中断次数较低(25.7%对5.7%,74.3%对94.3%,=0.045),目标喂养时间长度和ICU住院时间缩短,手术时间缩短,差异有统计学意义[(2.37±0.69)天对(3.49±0.74)天,=0.028;(8.52±5.45)天对(6.40±2.71)天,=0.022;(58.29±11.22)秒对(67.60±7.05)秒,=0.000]。应用床旁超声测量胃残余量可为神经外科重症患者肠内营养提供科学指导方法,可减少肠内营养中断次数,缩短目标喂养时间和ICU住院时间,减轻护士工作量。

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