超声监测胃残留量在ICU患者经鼻胃管肠内营养中的应用

Application of bedside ultrasound monitoring of gastric residual volume in ICU patients complicated with enteral nutrition support via nasogastric tube

目的探讨超声监测胃残留量在ICU患者经鼻胃管肠内营养中的应用。方法选取2017年11月至2018年5月在四川省肿瘤医院ICU经鼻胃管肠内营养的患者120例,按随机数字表法分为观察组和对照组各60例,观察组通过超声监测方法判断胃残留量,对照组通过50 ml注射器回抽方法判断胃残留量,根据测得的胃残留量适当调节肠内营养速度,比较2组发生反流、误吸和2组每日肠内营养时间的区别。结果观察组发生反流2例,低于对照组的10例,差异有统计学意义(χ2=4.53,P<0.05)。观察组发生误吸3例,低于对照组的11例,差异有统计学意义(χ2=3.96,P<0.05)。观察组每日肠内营养时间(13.98 ± 3.20)h,少于对照组的(15.54 ± 3.54)h,差异有统计学意义(t=-10.49,P<0.05)。结论对经鼻胃管肠内营养的ICU患者,使用超声监测胃残留量可以减少误吸、反流的发生,确保肠内营养的安全,同时能减少每日肠内营养时间。

Objective To discuss the application of bedside ultrasound monitoring of gastric residual volume in ICU patients complicated with enteral nutrition support via nasogastric tube. Methods November 2017 to May 2018, 120 patients with enteral nutrition support via nasogastric tube who admitted in ICU of our hospital were randomly divided into the observation group and the control group. The observation group used bedside ultrasound monitoring to determine the gastric residual volume, while the control group was estimated by withdrawn with 50 ml syringe. Reflux, pulmonary aspiration and the time of enteral nutrition were observed in both groups. ResultsReflux and pulmonary aspiration were present in 2, 3 in the observation group and 10, 11 in the control group, with significant difference between them (χ2=4.53, 3.96, P<0.05). The time of enteral nutrition in the observation group was (13.98±3.20) h, and (15.54±3.54) h in the control group, which had a statistically difference (t=-10.49, P<0.05). ConclusionThe application of bedside ultrasound monitoring of gastric residual volume in ICU patients complicated with enteral nutrition support via nasogastric tube can significantly reduce the risk of reflux and pulmonary aspiration which can ensure the safety of enteral nutrition, and decrease time of enteral nutrition.