腹腔间室综合征患者肠内营养支持的观察与护理

Observation and Nursing of Enteral Nutrition in Patients with Abdominal Compartment Syndrome

目的探索腹腔间室综合征患者进行肠内营养支持的观察与护理要点。方法患者复苏后,待肠水肿消退、肠道恢复通畅后经空肠途径实施肠内营养,观察营养指标及肠内营养并发症。结果21例患者实施肠内营养后,血总蛋白、白蛋白、前白蛋白、转铁蛋白、纤维连接蛋白水平均高于肠内营养前;肠内营养期间,发生腹泻14例(67%)、胃反流5例(23%)、呕吐2例(9.5%)、腹胀5例(23%)、高血糖2例(9.5%),经及时发现和处理.无不良后果、未发生导管相关并发症和误吸。结论腹腔间室综合征患者进行肠内营养支持可明显改善患者营养状况,维持肠黏膜屏障功能;护理工作中严密观察、预防和及时处理并发症是肠内营养顺利实施的保证。

Objective To study the application of enteral nutrition in patients with abdominal compartment syndrome and to explore its nursing strategy. Methods Twenty-one patients with abdominal compartment syndrome were given enteral nutrition after the initial resuscitation,disappearance of intestinal edema and recovery of intestinal potency; the nutritional indices and the complication were observed. Results The serum levels of total protein, albumin, proalbumin, transferrin, and fibronectin were up-regulated after enteral nutrition. Complications of enteral nutrition included diarrhea （ 14 cases, 67 %）, gastric reflex （ 5 cases, 23%）,vomiting （2 cases, 9.5%）, abdominal distention （5 cases, 23 %）, and hyperglycemia （ 2 cases, 9.5 % ）. All the complications were managed properly without adverse consequences. There was no aspiration and catheter-related complications. Conclusion Enteral nutrition in patients with abdominal compart- ment syndrome can obviously improve the nutritional status of patients and maintain the defense barrier function of the intestinal mucus. Intensive observation, prevention and management of complications are the key points for smooth application of enteral nutrition.