摘要
目的 探讨胃窗声学造影(GAW-CEUS)精准化肠内营养管理指导下的精准化肠内营养管理对重症监护病房(ICU)危重患者胃肠功能恢复的临床价值,评估其在改善胃动力学参数、优化营养代谢水平及降低多器官功能障碍综合征(MODS)发生风险方面的作用。方法 选取萍乡市第二人民医院2024年1月至2025年3月收治的60例ICU危重症患者,根据收治时间将其分为对照组[30例,胃管回抽胃残余量(GRV)评价,2024年1月至2024年7月]、研究组(30例,GAW-CEUS指导下精准化肠内营养管理,2024年8月至2025年3月)。比较2组胃肠功能恢复、胃动力学参数、营养代谢指标、MODS发生率。结论 研究组首次肠鸣音恢复、肠内营养达标及ICU停留时间均短于对照组(P<0.05)。与入院第1天相比,入院第2~7天2组GRV均呈降低趋势,且研究组均更低;2组胃排空时间均呈缩短趋势,且研究组均更短(P<0.05)。与入院第1天比较,入院第7天2组血清白蛋白、总蛋白和血红蛋白水平均升高,且研究组均更高(P<0.05)。住院期间,对照组、研究组MODS发生率分别为26.7%、6.7%,研究组更低(χ^(2)=4.320,P=0.038)。结论 GAW-CEUS指导下的精准化肠内营养管理可调节ICU危重患者胃动力学,促进胃肠功能恢复,缩短ICU住院周期,改善营养代谢状态,并降低MODS发生风险。
Objective To explore the clinical value of precise enteral nutrition management guided by gastric window contrast-enhanced ultrasonography(GAW-CEUS)for the recovery of gastrointestinal function in critically ill patients in the intensive care unit(ICU),and to evaluate its role in improving gastric kinetic parameters,optimizing nutritional metabolism and reducing the risk of multiple organ dysfunction syndrome(MODS).Methods A total of 60 critically ill ICU patients admitted to the Second People′s Hospital of Pingxiang from January 2024 to March 2025 were selected and divided into the control group[30 cases,evaluated by gastric tube withdrawal residual volume(GRV),January 2024 to July 2024]and the study group(30 cases,evaluated by GAW-CEUS,August 2024 to March 2025)according to the admission time.The recovery of gastrointestinal function,gastric kinetic parameters,nutritional and metabolic indicators,and the incidence of MODS were compared between the two groups.Results The first bowel sounds recovery,enteral nutrition standard and ICU stay time of the study group were shorter than those of the control group(P<0.05).Compared with the first day of admission,GRV of the two groups showed a decreasing trend from the second day to the seventh day of admission,and the GRV of the study group was lower.Both groups showed a trend of shortening,and the study group was shorter(P<0.05).On the first day of admission,the levels of serum albumin(ALB),total protein(TP)and hemoglobin(HB)in the two groups were higher than those on the seventh day of admission,and higher in the study group(P<0.05).During hospitalization,the incidence of MODS in the control group and the study group were 26.7%and 6.7%respectively,and the study group was lower(χ^(2)=4.320,P=0.038).Conclusion The precise enteral nutrition management under the guidance of GAW-CEUS can regulate the gastric dynamics of critically ill ICU patients,promote the recovery of gastrointestinal function,shorten the ICU hospitalization cycle,improve the nutritional metabolism status,and reduce the risk of MODS.
作者
林彩虹
刘玉洁
刘绍远
熊美娥
Lin Caihong;Liu Yujie;Liu Shaoyuan;Xiong Mei'e(Department of Ultrasound,Pingxiang Second People's Hospital,Pingxiang 337000,China;Department of Emergency,Pingxiang People's Hospital,Pingxiang 337000,China)
出处
《实用医技杂志》
2025年第12期915-918,共4页
Journal of Practical Medical Techniques
基金
江西省卫生健康委科技计划(202410735)。
关键词
肠道营养
危重病人医疗
胃肠疾病
胃窗声学造影
Enteral nutrition
Critical care
Gastrointestinal diseases
Gastric window contrast echocardiography
