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中国临床研究英文版:2023,36(5):789-791,796
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腹内压监测在指导重症卒中患者肠内营养中的应用
(1. 青岛大学附属医院,山东 青岛 266000;2. 青岛市市立医院,山东 青岛 266000)
Application of intra-abdominal pressure monitoring in guiding enteral nutrition in patients with severe stroke
摘要
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Received:February 16, 2023   Published Online:May 20, 2023
中文摘要: 目的 观察腹内压监测在重症卒中患者肠内营养中的应用效果,指导临床肠内营养治疗。方法 选择青岛大学附属医院神经外科监护室(NICU)2021年7月至2023年1月收治的重症卒中早期启动肠内营养的患者78例,采用随机数字表法将患者分观察组(腹内压监测组)和对照组(常规胃残余量监测组),各39例。对照组采用常规胃残余量监测方式每4 h使用注射器回抽胃内容物,观察组采用腹内压监测方式,每4 h测量患者腹内压。比较两组肠内营养目标喂养量达标时间、第7天喂养达标率、喂养不耐受发生率、白蛋白、急性生理与慢性健康状况评分(APACHEⅡ)以及NICU住院时间。结果 干预后,观察组肠内营养目标喂养量达标时间、第7天喂养达标率、喂养不耐受发生率、白蛋白以及APACHEⅡ评分均优于对照组(P<0.05);NICU住院时间差异无统计学意义(P>0.05)。结论 重症卒中患者早期启动肠内营养,采用腹内压监测指导,可显著缩短患者目标喂养量达标时间、提高患者肠内营养治疗效果、改善患者预后。
Abstract:Objective To observe the application effect of intra-abdominal pressure (IAP) monitoring in enteral nutrition of patients with severe stroke, and guide clinical enteral nutrition treatment. Methods A total of 78 patients with severe stroke who received early enteral nutrition in Neurosurgical Care Unit (NICU) of the Affiliated Hospital of Qingdao University from July 2021 to January 2022 were selected. The patients were divided into observation group (intra-abdominal pressure monitoring group) and control group (conventional gastric residue monitoring group) by random number table method, with 39 patients in each group. The patients in control group used the routine gastric residue monitoring method to pump the gastric contents back with a syringe every 4 hours. The observation group used the intra-abdominal pressure monitoring method to measure the intra-abdominal pressure of patients every 4 hours. The time when the target feeding amount of enteral nutrition reached the standard, the rate of feeding up to the standard on the 7th day, the incidence of feeding intolerance, serum nutritional indicators, acute physiology and chronic health evaluation (APACHEⅡ) and NICU hospital stay were compared between two groups. Results After intervention, the observation group was superior to the control group in terms of the time to reach the target feeding amount for enteral nutrition, the rate of reaching the target feeding rate on the 7th day, the incidence of feeding intolerance, albumin, and APACHEⅡ scores (P<0.05); There was no statistically significant difference in the length of stay in NICU (P>0.05). ConclusionsFor patients with severe stroke who start enteral nutrition early, using intraperitoneal pressure monitoring guidance can significantly shorten the time for patients to reach the target feeding amount, improve the therapeutic effect of enteral nutrition, and improve the prognosis of patients.
文章编号:     中图分类号:R473.74    文献标志码:B
基金项目:国家自然科学基金(81971893)
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