流体测压法监测肠道压力在神经重症患者早期肠内营养治疗中的应用

Application of Fluid Manometry to Monitor Intestinal Pressure in Early Enteral Nutrition Treatment of Patients with Severe Neurological Conditions

目的:探究流体测压法监测肠道压力在神经重症患者早期肠内营养治疗中的应用。方法:选取2022年6月至2023年5月河南省人民医院收治的90例留置鼻空肠营养管的神经重症患者,按照随机数字表法分为常规组和流体测压组,各45例。常规组采用测腹围,听肠鸣音的方式评估患者肠道功能,流体测压组采用流体测压法监测肠道压力及肠道功能。比较两组患者喂养达标情况、喂养不耐受情况、营养指标及疾病严重状态。结果:流体测压组患者调整肠内营养时间、肠内营养喂养达标时间、重症监护室(ICU)住院时间短于常规组,第5天肠内营养达标率高于常规组,差异具有统计学意义(P<0.05)。流体测压组患者喂养不耐受总发生率低于常规组,差异具有统计学意义(P<0.05)。干预后,两组患者血清白蛋白、前白蛋白水平高于干预前,急性生理与慢性健康状况评分(APACHE)低于干预前,且流体测压组血清白蛋白、前白蛋白水平高于常规组,APACHE低于常规组,差异具有统计学意义(P<0.05)。结论:在神经重症患者早期肠内营养治疗中应用流体测压法监测肠道压力,可提高患者肠内营养达标率,有效降低神经重症患者肠内营养喂养不耐受情况。

Objective To explore the application of fluid manometry to monitor intestinal pressure in early enteral nutrition treatment of patients with severe neurological conditions.Methods A total of 90 patients with severe neurological conditions who had nasal jejunal nutrition tube placed in Henan Provincial People's Hospital from June 2022 to May 2023 were selected and divided into the conventional group and the fluid pressure measurement group according to random number table method,with 45 cases in each group.The conventional group assessed the intestinal function by measuring abdominal circumference and listening to intestinal sounds,while the fluid pressure measurement group monitored the intestinal pressure and intestinal function by fluid manometry.Compare the feeding compliance,feeding intolerance,nutritional indicators,and disease severity between the two groups of patients.Results The adjustment time of enteral nutrition,the standard feeding time of enteral nutrition and the length of intensive care unit(ICU)stay in the fluid pressure measurement group were shorter than those in the conventional group,and the rate of enteral nutrition compliance on the 5th day was higher than that in the conventional group,the differences were statistically significant(P<0.05).The total incidence of feeding intolerance in the fluid pressure measurement group was lower than that in the conventional group,and the difference was statistically significant(P<0.05).After intervention,the levels of serum albumin and prealbumin in the two groups were higher than those before intervention,the acute physiology and chronic health evaluation score(APACHE)was lower than that before intervention,and the levels of serum albumin and prealbumin in the fluid pressure measurement group were higher than those in the conventional group,and APACHE was lower than that in the conventional group,with statistical significance(P<0.05).Conclusion The application of fluid manometry to monitor intestinal pressure in the early enteral nutrition treatment of patients with severe neurological conditions can improve the rate of enteral nutrition compliance and effectively reduce the enteral nutrition feeding intolerance of patients with severe neurological conditions.