腹内压监测对危重患者早期空肠营养实施的影响

Study on the impact on the early enterai nutrition implementation for critically sick patients with intra-abdominal pressure monitoring

目的探讨腹内压升高对危重患者早期空肠营养实施的影响。方法对59例危重患者入ICU后,在开始实施空肠营养之前,给予测量腹内压,每4 h测1次,连测6次,取平均值,将腹内压<0.665 kPa的患者分为腹内压正常组(A组),0.665 kPa<腹内压<1.995 kPa的患者分为腹内压升高组(B组),观察两组患者实施空肠营养后发生腹胀、腹泻情况和暂停空肠营养的机率。结果B组患者腹胀、腹泻发生率与暂停空肠营养机率明显高于A组,P<0.05,差异有统计学意义。结论患者腹内压越高,出现腹胀、腹泻并发症越多,暂停空肠营养机率也越高,所以危重患者早期空肠营养应密切监测腹内压变化,通过反复尝试,对症处理,预防并发症发生,逐步达到早期空肠营养的目的。

Objective To investigate the impact on the early enternal nutrition implementation for critically sick patients with intra-abdominal pressure. Method The intra-abdominal pressure of 59 critically sick patients was measured every four hours after their entry into ICU and prior to the nutrition implementation, the measuring was conducted 6 times in succession and taking the average, then divide the patients into 2 groups, groups A with intra-abdominal pressure less than 5 mmHg （normal pressure group） and group B with intra-abdominal pressure more than or equal to mmHg and less than 15mmHg （hypertension group）. The two groups are observed for the occurrence of abdominal distention, diarrhea and suspension of enteral nutrition after the nutrition implementation. Result The incidence rate of abdominal distension, diarrhea and the suspension enternal nutrition is Group B is remarkably higher than that in Group A, there was significant difference （P〈0. 05）. Conclusion The higher intra-abdominal pressure contributes to the higher complication of abdominal distension and diarrhea, higher incidence of enternal nutrition suspension, thus critically sick patients should be closely monitored for their charges of intra-abdominal pressure in the course of early enternal nutrition implementation. Through repeated trials and symptomatic treatment the complication is prevented and the early enternal nutrition is gradually implemented.