早期系统肠道刺激对机械通气患者的影响

Effect of early systematic intestinal stimulation on patients with mechanical ventilation

目的：观察对机械通气患者实施早期系统肠道刺激对患者病情的影响。方法将94例有创机械通气患者按随机数字表法随机分为干预组及对照组各47例。干预组实施早期系统肠道刺激，对照组按护理常规。比较两组患者观察期结束时的APACHEⅡ评分，机械通气天数、多器官功能障碍综合征（ MODS）发病率、ICU住院天数、病死率。结果两组患者干预前APACHEⅡ评分比较差异无统计学意义（P＞0．05）；观察期结束时的干预组患者APACHEⅡ评分为（14．60±7．95）分，低于对照组和干预前评分（18．38±8．24），（19．57±2．64）分，差异有统计学意义（t值分别为-2．268，-4．841；P＜0．05）；剔除死亡患者后对照组干预前后的APACHEⅡ评分分别为（19．47±2．28），（15．34±1．63）分，差异有统计学意义（t＝-13．077，P＜0．01）；干预组干预前后及两组干预后组间比较差异均有统计学意义（P＜0．01）；干预组患者机械通气时间为（7．66±6．89）d，低于对照组（11．96±8．19）d，差异有统计学意义（t＝-2．753，P＜0．01），但ICU 住院时间、MODS 发病率、病死率比较差异均无统计学意义（ P ＞0．05）。结论对机械通气患者预防性的实施早期肠道刺激可改善患者病情，缩短机械通气时间。

Objective To explore the effect of early systematic intestinal stimulation on patients with mechanical ventilation .Methods Ninety-four patients with mechanical ventilation were chosen and divided into the control group and the observation group according to the random number table , each with 47 cases.The control group received the routine nursing , and the observation group received the early systematic intestinal stimulation.The score of APACHEⅡscale, the days of mechanical ventilation , the incidence rate of multiple organ dysfunction syndrome （ MODS ） , the days of hospitalization in ICU and the mortality were compared between two groups .Results No difference was found in the score of APACHEⅡ scale before the intervention between two groups （P〉0.05）.The score of APACHEⅡscale was （14.60 ±7.95） in the observation group after the intervention, and was lower than （18.38 ±8.24） in the control group and （19.57 ±2.64） before the intervention, and the differences were statistically significant （t=-2.268,-4.841, respectively;P〈0.05）. The scores of APACHEⅡ scale were respectively （19.47 ±2.28）, （15.34 ±1.63） in the control group exclude the death cases before and after the intervention , and the difference was statistically significant （ t=-13.077,P〈0.01）.The days of mechanical ventilation was （7.66 ±6.89） d in the observation group, and was lower than （11.96 ±8.19） d in the control group, and the difference was statistically significant （t =-2.753,P〈0.01）.No differences were found in the incidence rate of MODS , the days of hospitalization in ICU and the mortality between two groups （P 〉0.05）.Conclusions The preventive implement of early systematic intestinal stimulation on patients with mechanical ventilation can improve the condition of patients , and shorten the duration of mechanical ventilation .