摘要
目的:探讨床旁超声胃窦双径法预估胃残余量(GRV)指导老年重症病人肠内营养实施应用价值。方法:选取2019年1月至2021年6月收住本院重症医学科需行肠内营养的老年重症病人共60例。按照数字表法随机分为对照组和超声组。对照组采用注射器回抽法,超声组采取超声监测GRV,指导肠内营养实施。观察两组病人基线水平、肠内营养并发症及预后指标。结果:两组的基线特征无显著性差异(P> 0.05)。两组肠内营养不耐受发生率、ICU住院时间和判断GRV所需时间方面差异无统计学意义(P> 0.05)。与对照组相比,超声组喂养达标时间更短[(4.73±0.77) vs (5.41±1.16),P=0.01],28 d无机械通气时间更长[21.67 (13.02, 26.31) vs 20.32 (7.50,25.79),P=0.04]。结论:采用床旁超声监测GRV来指导肠内营养实施可以更快地达到目标喂养目标,缩短机械通气时间。
Objective: To explore the value of ultrasound monitoring of gastric residual volume(GRV) to guide the implementation of enteral nutrition in elderly critically ill patients. Methods: From January 2019 to June 2021, 60elderly patients who needed enteral nutrition in ICU of our hospital were admitted. They were randomly divided into a control group and an ultrasound group. Patients in the ultrasound group were given bedside ultrasound to monitor GRV,twice a day, to guide the implementation of enteral nutrition. Patients in the control group were monitored by the syringe retraction method every 4 hours. The baseline level, enteral nutrition complications and prognostic indexes of the two groups were recorded. Results: there was no significant difference in baseline characteristics between the two groups(P > 0.05). There was no significant difference in the incidence of enteral nutrition intolerance, length of stay in ICU and the time required to judge GRV between the two groups(P > 0.05). Compared with the control group, the time of reaching the goal volume by enteral nutrition was shorter [(4.73 ± 0.77) vs(5.41 ± 1.16), P = 0.01], and the time without mechanical ventilation for 28 days was longer [21.67(13.02, 26.31) vs 20.32(7.50, 25.79), P = 0.04] in the ultrasound group. Conclusion: using bedside ultrasound to monitor GRV to guide the implementation of enteral nutrition can achieve the target feeding goal faster and shorten the time of mechanical ventilation.
作者
江洁
罗倩
朱宝华
张茜
JIANG Jie;LUO Qian;ZHU Bao-hua;ZHANG Qian(Department of Critical Care Medicine,Nanjing Central Hospital,Nanjing 210018,Jiangsu,China;Department of Critical Care Medicine,Zhongda Hospital,School of Medicine,Southeast University,Nanjing 210009,Jiangsu,China)
出处
《肠外与肠内营养》
CAS
CSCD
北大核心
2022年第5期280-284,共5页
Parenteral & Enteral Nutrition
基金
南京市医学科技发展项目(YKK18236)
南京市青年人才支持项目(QRX17104)
关键词
危重症
老年病人
肠内营养
床旁超声
胃残余量
ICU
Elderly patients
Enteral nutrition
Bedside ultrasound
Gastric residual volume
作者简介
江洁,副主任医师,医学博士研究生,主要从事重症营养研究。E-mail:15077871218@139.com;通讯作者:江洁,E-mail:15077871218@139.com
