神经外科重症患者胃潴留的动态观察及与血糖、昏迷程度的相关分析

Dynamic Observation of Gastric Retention in Severe Cases of Neurosurgery and Its Correlation with Blood Glucose and Coma Extent

目的:调查分析神经外科重症患者胃潴留好发时间段及血糖和昏迷程度对胃潴留的影响。方法:对入住神外ICU且行鼻饲喂养的神经外科重症患者每隔4小时监测胃残余量、血糖、格拉斯哥昏迷评分(GCS)以及格拉斯哥预后评分(GOS),共观察10天。统计分析胃潴留好发时间段及血糖和昏迷程度对胃潴留的影响。结果:在使用胃肠营养泵严格控制速度的情况下,76.4%的患者发生胃潴留,其中76.9%的患者在第6、7天发生胃潴留,血糖及病人的昏迷程度与胃潴留分别呈低度相关及中度相关。胃滞留与患者预后呈中度相关。结论:胃潴留是神经外科重症患者常见的并发症,好发于鼻饲喂养后的第6、7天,对血糖较高及GCS较低患者的应加强监护。

Objective：A group of severe cases of neurosurgery were involved to investigate the time internal when gastric retention occurred frequently.The influence of blood glucose and coma extent on gastric retention was also inspected.Methods：For these 17 in-patients in neurosurgery ICU ward, once the nasogastric feeding started, gastral residual volume,blood glucose,Glasgow coma score （GCS） and Glasgow outcome score （GOS） were investigated every four hours for ten days.The time internals when gastric retention occurred most frequently were under statistic analysis along with the correlation between gastric retention and blood glucose or coma extent.Results：By using enteral feeding pump to control the speed strictly,13（76.4%） patients had gastric retention. Among them,10（76.9%） started to have gastric retention on Day 6 or 7.The correlation grade between the blood glucose and gastral retention was low while it was moderate for coma extent and gastral retention. The gastral retention was moderately correlated with the outcome.Conelusions：Gastric retention is one of the frequent complications for severe cases of neurosurgery. It may easily occurred 6 or 7 days after the nasogastric feeding starts. Intensive care about gastral retention is necessary for patients with hyperglycemia or low GCS.