生大黄灌肠联合腹内压监测在危重症患者肠内营养治疗中的应用效果

Effects of rhubarb enema combined with intra-abdominal pressure monitoring in enteral nutrition therapy among critical patients

目的探讨生大黄灌肠联合腹内压监测在危重症患者肠内营养治疗中的临床应用效果。方法采用便利抽样法,选取2017年8月-2018年8月于杭州某三甲医院重症医学科行肠内营养的68例患者为研究对象,按随机分组的方法将其分为试验组和对照组,每组各34例。对照组实施腹内压监测指导肠内营养治疗。试验组在此基础上加用生大黄灌肠,疗程5 d。比较两组患者急性生理与慢性健康状况评分Ⅱ(APACHEⅡ)评分、腹内压、喂养不耐受发生率(FI)、达目标喂养量的时间。结果干预后,试验组患者APACHEⅡ评分低于对照组,两组得分比较差异无统计学意义(P>0.05);试验组患者腹内压低于对照组患者,两组比较差异有统计学意义(P<0.01);试验组达目标喂养量时间短于对照组,两组比较差异有统计学意义(P<0.01);试验组FI发生率低于对照组,两组比较差异有统计学意义(P<0.05)。结论生大黄灌肠联合腹内压监测可以降低危重症患者腹内压,缩短达目标喂养量的时间,降低FI发生率。

Objective To explore the effects of rhubarb enema combined with intra-abdominal pressure(IAP)monitoring in enteral nutrition(EN)therapy among critical patients.Methods From August 2017 to August 2018,this study selected 68 EN patients of ICU at a ClassⅢGrade A hospital in Hangzhou as subjects by convenience sampling.All of patients were randomly divided into experimental group and control group,34 cases in each group.Control group carried out the EN treatment guided by IAP monitoring.On the basis,experimental group combined the rhubarb enema for 5 days.This study compared the score of Acute Physiology and Chronic Health Evaluation(APACHE)Ⅱ,IAP,incidence of feeding intolerance(FI)and feeding volume reaching the standard of patients between two groups.Results After intervention,the score of APACHEⅡof patients in experimental group was lower than that in control group with no statistical difference(P>0.05).The IAP of patients in experimental group was lower than that in control group with a statistical difference(P<0.01).The time of feeding volume reaching the standard of patients in experimental group was shorter than that in control group with a statistical difference(P<0.01).The incidence of FI of experimental group was lower than that in control group with a statistical difference(P<0.05).Conclusions Rhubarb enema combined with IAP monitoring can reduce the IAP of critical patients,shorten the time of feeding volume reaching the standard and reduce the incidence of FI.