床旁超声监测胃残余量指导重症患者肠内营养的应用观察
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摘要
目的:观察床旁超声监测胃残余量指导重症患者肠内营养的应用效果。方法:选取2017年5月-2018年5月本院收治的60例重症患者,均提供长期肠内营养治疗。按照随机数字表法将其分为观察组与对照组,各30例。观察组行床旁超声监测胃残余量指导下肠内营养治疗,对照组采用回抽胃液法干预。比较两组并发症发生情况、肠内营养达标时间、血浆总蛋白、调整肠内营养时间、对肠内营养治疗依从率。结果:观察组并发症发生率为13.33%,低于对照组的40.00%(字2=18.187,P=0.000);观察组肠内营养达标时间、调整肠内营养时间均短于对照组,血浆总蛋白水平高于对照组,比较差异均有统计学意义(P<0.05);观察组对肠内营养治疗完全依从率高于对照组,部分依从率、不依从率均低于对照组,比较差异均有统计学意义(P<0.05)。结论:医护人员为重症患者提供床旁超声监测胃残余量指导下肠内营养治疗,可降低并发症发生率,提高患者血浆总蛋白,缩短肠内营养治疗时间。
Objective:To observe the application of gastric residual volume monitoring under the bedside ultrasound guidance for critical patient's enteral nutrition support.Method:A total of 60 critical patients underwent the long-term enteral nutrition therapy from May 2017 to May 2018 in our department were selected.According to the random number table method,they were divided into observation group and control group,30 cases in each group.The observation group was treated with enteral nutrition under the guidance of bedside ultrasound monitoring gastric remnants,while control group was treated with gastric juice withdrawal method.The complications,time of reaching the standard of enteral nutrition,total plasma protein,time of adjusting enteral nutrition and compliance rate of enteral nutrition treatment between two groups were compared.Result:The total incidence of complications in observation group was 13.33%,which was lower than 40.00% in control group( 字2=18.187,P=0.000).The time of reaching the standard of enteral nutrition and adjusting enteral nutrition in observation group were shorter than those of control group,the total plasma protein level was higher than that of control group,the differences were statistically significant(P<0.05).The complete compliance rate of enteral nutrition treatment in observation group was higher than that of control group,the partial compliance rate and noncompliance rate were lower than those of control group,the differences were statistically significant(P<0.05).Conclusion:Medical staff provide bedside ultrasound monitoring of gastric remnants to guide enteral nutrition treatment for critically patients,which can reduce the incidence of complications,increase the total plasma protein of patients,and shorten the time of enteral nutrition treatment.
Objective:To observe the application of gastric residual volume monitoring under the bedside ultrasound guidance for critical patient's enteral nutrition support.Method:A total of 60 critical patients underwent the long-term enteral nutrition therapy from May 2017 to May 2018 in our department were selected.According to the random number table method,they were divided into observation group and control group,30 cases in each group.The observation group was treated with enteral nutrition under the guidance of bedside ultrasound monitoring gastric remnants,while control group was treated with gastric juice withdrawal method.The complications,time of reaching the standard of enteral nutrition,total plasma protein,time of adjusting enteral nutrition and compliance rate of enteral nutrition treatment between two groups were compared.Result:The total incidence of complications in observation group was 13.33%,which was lower than 40.00% in control group( 字2=18.187,P=0.000).The time of reaching the standard of enteral nutrition and adjusting enteral nutrition in observation group were shorter than those of control group,the total plasma protein level was higher than that of control group,the differences were statistically significant(P<0.05).The complete compliance rate of enteral nutrition treatment in observation group was higher than that of control group,the partial compliance rate and noncompliance rate were lower than those of control group,the differences were statistically significant(P<0.05).Conclusion:Medical staff provide bedside ultrasound monitoring of gastric remnants to guide enteral nutrition treatment for critically patients,which can reduce the incidence of complications,increase the total plasma protein of patients,and shorten the time of enteral nutrition treatment.
引文
[1]曹岚,叶向红,李君,等.床旁超声监测胃残余量在神经外科重症患者肠内营养中的应用[J].中华医学杂志,2017,97(9):675-678.
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[10]赵庆华,皮红英,周颖,等.超声检测与注射器抽吸肠内营养患者胃残余量比较[J].护理学杂志,2017,32(12):54-55.
[11]王军.床旁超声监测胃残余量指导重症患者肠内营养的应用观察[J].基层医学论坛,2015,19(18):2518-2519.
[12]邓岩军,吴雪梅,谢红,等.超声测定胃排空功能指导重症机械通气患者肠内营养的临床应用[J].中华老年多器官疾病杂志,2016,15(7):533-536.
[13]潘灵爱,黄晓波,王艺萍.超声监测胃残余量在风心病合并恶液质病人术后肠内营养中的应用[J].肠外与肠内营养,2018,25(1):43-45,51.
[14]封秀琴.超声引导下改良胃内注气法留置鼻肠管在严重创伤患者中的临床应用[D].杭州:浙江大学,2014.
[15]冷英杰,丁婷,缪羽,等.超声辅助法置入经鼻空肠营养管在急性重症胰腺炎中的应用与护理[J].东南国防医药,2015,17(5):502-505.
[16]陈卫挺,陈仁辉,陈英姿,等.床旁超声监测胃残余量在机械通气危重患者肠内营养中的应用[J].中国乡村医药,2018,25(5):18-19.
[17]陈英姿,陈仁辉,陈卫挺,等.床旁超声胃窦运动指数指导ICU机械通气危重患者肠内营养的应用价值[J].浙江临床医学,2018,20(5):891-892,895.
[18]戴雪榕,吴敏,沈雁波.机械通气患者使用床旁超声指导肠内营养的护理研究[J].交通医学,2017,31(4):396-397,406.
[19]袁媛,马小静,柳梅,等.超声检查测定胃动力指导心脏手术后机械通气患儿肠内营养应用的临床研究[J].中华小儿外科杂志,2013,34(6):420-423.
[20]叶瑞忠,范小明,王立刚,等.改良超声方法在重症患者留置鼻肠管头端定位中的初步应用[J].中华临床营养杂志,2016,24(4):199-202.
[2]王濯,沈梅芬.监测胃残余量在危重症患者肠内营养中应用效果的系统评价[J].护士进修杂志,2016,31(5):406-409.
[3]陈艳,林相彬,陶福正,等.超声监测胃残余量在基层医院ICU中的应用[J].浙江临床医学,2018,20(3):530-532.
[4]丁瑜,侯惠如,李英男,等.肠内营养患者胃残余量监测的研究进展[J].安徽医药,2018,22(2):212-215.
[5]赵庆华,皮红英,周玉虹,等.危重症患者肠内营养期间胃残余量监测情况调查[J].中华现代护理杂志,2016,22(20):2881-2885.
[6]赵庆华,皮红英,周颖,等.ICU住院患者胃残余量监测相关情况调查分析[J].护士进修杂志,2017,32(6):553-556.
[7]高扬,刘世迎,逄红,等.颅脑损伤患者肠内营养期间胃残余量状况监护研究[J].中国实用护理杂志,2018,34(12):895-899.
[8]刘静,邵小平.腹内压联合胃残余量监测在ICU患者护理中的应用[J].解放军医院管理杂志,2016,23(12):1184-1186.
[9]丁瑜,王刚石,张颖,等.白利度计与超声测量肠内营养患者胃残余量的对比研究[J].中华内科杂志,2017,56(12):940-942.
[10]赵庆华,皮红英,周颖,等.超声检测与注射器抽吸肠内营养患者胃残余量比较[J].护理学杂志,2017,32(12):54-55.
[11]王军.床旁超声监测胃残余量指导重症患者肠内营养的应用观察[J].基层医学论坛,2015,19(18):2518-2519.
[12]邓岩军,吴雪梅,谢红,等.超声测定胃排空功能指导重症机械通气患者肠内营养的临床应用[J].中华老年多器官疾病杂志,2016,15(7):533-536.
[13]潘灵爱,黄晓波,王艺萍.超声监测胃残余量在风心病合并恶液质病人术后肠内营养中的应用[J].肠外与肠内营养,2018,25(1):43-45,51.
[14]封秀琴.超声引导下改良胃内注气法留置鼻肠管在严重创伤患者中的临床应用[D].杭州:浙江大学,2014.
[15]冷英杰,丁婷,缪羽,等.超声辅助法置入经鼻空肠营养管在急性重症胰腺炎中的应用与护理[J].东南国防医药,2015,17(5):502-505.
[16]陈卫挺,陈仁辉,陈英姿,等.床旁超声监测胃残余量在机械通气危重患者肠内营养中的应用[J].中国乡村医药,2018,25(5):18-19.
[17]陈英姿,陈仁辉,陈卫挺,等.床旁超声胃窦运动指数指导ICU机械通气危重患者肠内营养的应用价值[J].浙江临床医学,2018,20(5):891-892,895.
[18]戴雪榕,吴敏,沈雁波.机械通气患者使用床旁超声指导肠内营养的护理研究[J].交通医学,2017,31(4):396-397,406.
[19]袁媛,马小静,柳梅,等.超声检查测定胃动力指导心脏手术后机械通气患儿肠内营养应用的临床研究[J].中华小儿外科杂志,2013,34(6):420-423.
[20]叶瑞忠,范小明,王立刚,等.改良超声方法在重症患者留置鼻肠管头端定位中的初步应用[J].中华临床营养杂志,2016,24(4):199-202.