危重症患者肠内营养期间胃残余量监测情况调查

Investigation on the monitoring of residual gastric residual in critical patients with enteral nutrition

目的了解ICU护士对肠内营养期间胃残余量（GRV）监测的认识及操作现状。方法本研究主要采取问卷调查法，调查问卷在参考有关文献及专家咨询的基础上自行设计，对111名ICU护士GRV监测行为及认识进行调查。结果被调查的111名护理人员中，“经常应用”肠内营养治疗的占81．1％（90／111）；护理人员对GRV监测方案或流程了解情况方面，被调查表示，科室具有明确的GRV监测方案的占82．9％（92／111），仍有17．1％（19／111）的被调查者表示，科室内部缺少明确的GRV的监测方案。护理人员对GRV监测工具的认识情况，72．1％的被调查者选择“50或60ml注射器”，23．4％的被调查者选择“胃肠减压装置”。护理人员对评估GRV过多标准了解情况方面，GRV达200m1占48．6％（54／111），达100ml占33．3％，达150nrl占7．2％，达500ml占6．3％，达250ml占0．9％，不确定占3．6％（4／111）。护理人员对胃残留物处理方法了解情况方面，74．8％（83／111）的被调查者选择“弃去”，22．5％（25／111）的被调查者选择“未统一规定”，仅有2．7％（3／111）的被调查者选择“重新注入”。结论应加强ICU护士在患者肠内营养期间相关知识的培训及先进理念的更新，以确保危重症患者肠内营养支持的安全性和有效性。

Objective To investigate the ICU nurses＇ knowledge for gastric residual volume monitoring during the period of enteral nutrition and the normative operation. Methods A total of 111 nurses from ICU were investigated using questionnaires for behavior and understanding of gastric residual volume monitoring. Questionnaires were self-designed basing on references and expert consultation. Results Among 111 nurses, 81.1% nurses （90/111） used ＇frequently applied＇ enteral nutrition. During the investigation of nurses＇ knowledge for gastric residual volume monitoring procedures, 82.9% （92/111） nurses＇ department had clear and specific GRV monitoring approach, while 17.1% （ 19/111 ） respondents＇ departments were lack of clear GRV monitoring approach. Considering knowledge of GRV monitoring tools, 72.1% nurses used ＂50 or 60 ml syringe＂ and 23.4% nurses used gastrointestinal decompression devices. Ratio of nurses＇ assessment of GRV excessive amount were 48.6% ,33.3% ,7.2% ,6.3% ,0.9% and 3.6% for 200 ml, 100 ml, 150 ml,500 ml,250 ml and uncertainty respectively. On the behalf of how to deal with gastric residual, 74.8% （83/111 ） nurses chose discarding, 22. 5% （ 25/111 ） nurses answered ＇ inexact administration＇ and only 2. 7% （ 3/111 ） considered ＇ reinjection＇. Conclusions Nurses in ICU should be trained and strengthened on the knowledge of patients with enteral nutrition and advanced concepts updating so as to ensure the safety and effectiveness of enteral nutrition support in critical patients.