胃肠道功能障碍分级干预在危重症患者中的应用

The effect of improved AGI grading intervention program on gastrointestinal dysfunction in critically ill patients

目的探究胃肠道功能障碍分级干预在危重患者中的应用效果。方法在我院ICU中选取符合标准的胃肠道功能障碍患者78例,随机分为实验组和对照组,实验组应用胃肠道功能障碍分级干预方案进行护理,对照组给予常规护理和治疗,观察两组的血清白蛋白、氮平衡、总蛋白水平,记录患者24 h、48 h喂养率、7 d热量达标率、机械通气持续时间、ICU住院时间、总住院时间、ICU病死率、ICU获得性感染率。结果实验组的24 h、48 h喂养率、7 d热量达标率高于对照组,差异有统计学意义(均P<0.05),两组的总蛋白、氮平衡、血清白蛋白比较,差异有统计学意义(均P<0.05)。实验组的机械通气时间、ICU住院时间和总住院时间较对照组显著缩短,差异有统计学意义(均P<0.05),两组的ICU病死率、ICU获得性感染率比较,差异无统计学意义(P>0.05)。结论对危重患者实施胃肠道功能障碍分级干预,能提高患者的24 h、48 h喂养率、7 d热量达标率及血清白蛋白、氮平衡、总蛋白水平,可以缩短患者的机械通气时间、ICU住院时间和总住院时间。

Objective To study the effect of improved GIF grading intervention program on gastrointestinal dys- function in critically ill patients. Methods A total of 78 patients with gastrointestinal dysfunction were randomly divided into the experimental group and control group. The patients in the experimental group were treated with modified GIF classification program to evaluate the gravitational status of patients with severe gastrointestinal dys- function and the control group received routine nursing and treatment. The levels of serum albumin（ALB）,nitrogen balance（NB） and total protein（TP） were recorded in two groups,and the feeding rate of the patients was recorded at 24 and 48 hours. The calorie qualifying rate at 7d,duration of mechanical ventilation,ICU length of stay,total length of stay in hospital,ICU mortality,ICU acquired infection rate were recorded. Results Feeding rate at 24 h and 48 h, calorie qualifying rate at 7d in the experimental group were significantly higher than those in the control group （P〈0.05）; there were significant differences between two groups in TP,NB,and ALB （P〈0.05）. Mechanical ventilation duration,ICU length of stay,and total length of stay in hospital were significantly shortened in the experi- mental group（P〈0.05）;there were no significant differences between two groups in ICU mortality and ICU acquired infection rate（P〉0.05）. Conclusion The improvement of AGI grading intervention in patients with severe gastroin- testinal dysfunction can improve at 24 h,48 h,calorie qualifying rate at 7 d and TP,NB and ALB levels,reduce the time of mechanical ventilation,reduce total length of stay in hospital.