超声监测胃残余量在ICU有创机械通气鼻饲患者中的应用

Ultrasonic monitoring of gastric residual volume in patients with invasive mechanical ventilation and nasal feeding in ICU

目的观察超声监测胃残余量在重症监护室(ICU)有创机械通气鼻饲患者中的应用效果。方法抽取郑州市第九人民医院2018年5月至2021年6月收治的109例ICU有创机械通气鼻饲患者,根据患者床位号单双号分为对照组(55例)与研究组(54例)。对照组采用常规方法监测胃残余量,研究组采用超声监测胃残余量,干预至鼻饲喂养结束。干预7 d,检测并比较两组营养指标[血红蛋白(Hb)、白蛋白(ALB)、转铁蛋白(TF)];记录并比较两组机械通气时间与ICU住院时间、并发症发生情况。结果干预前,两组Hb、ALB、TF水平比较差异未见统计学意义(P>0.05);干预7 d,研究组Hb、ALB、TF水平均高于对照组(P均<0.05);研究组机械通气时间与ICU住院时间[(9.32±2.14)、(12.32±2.85)d]均短于对照组[(13.85±2.32)、(17.55±2.93)d],P均<0.05;研究组胃内容物反流、误吸发生率(5.56%,3/54;1.85%,1/54)均低于对照组(25.45%,14/55;18.18%,10/55),P均<0.05。结论ICU有创机械通气鼻饲患者采用超声监测胃残余量可促进营养物质吸收,缩短机械通气时间与ICU住院时间,减少相关并发症发生。

Objective To observe the application effect of ultrasonic monitoring of gastric residual volume in patients with invasive mechanical ventilation and nasal feeding in intensive care unit(ICU).Methods One hundred and nine patients with invasive mechanical ventilation and nasal feeding in ICU of the Ninth People’s Hospital of Zhengzhou from May 2018 to June 2021 were selected.According to parity of bed number of patients,they were divided into control group(55 cases)and study group(54 cases).The control group used the routine method to monitor the gastric residual volume,and the study group used ultrasound to monitor the gastric residual volume,the intervention was completed until the nasal feeding was finished.The nutritional indexes including hemoglobin(Hb),albumin(ALB),transferrin(TF)of the two groups were detected and compared 7 days after intervention;the time of mechanical ventilation,hospitalization time of ICU and complications of the two groups were recorded and compared.Results There was no significant difference in Hb,ALB and TF levels between the two groups before intervention(P>0.05);7 days after intervention,the levels of Hb,ALB and TF in the study group were higher than those in the control group(all P<0.05).The time of mechanical ventilation and hospitalization time of ICU in the study group were(9.32±2.14)d and(12.32±2.85)d,shorter than the(13.85±2.32)d and(17.55±2.93)d of the control group(all P<0.05).The incidences of gastric reflux and aspiration complications in the study group(5.56%,3/54;1.85%,1/54)were lower than those in the control group(25.45%,14/55;18.18%,10/55),all P<0.05.Conclusions Ultrasonic monitoring of gastric residual volume in patients with invasive mechanical ventilation and nasal feeding in ICU can promote nutrient absorption,shorten the time of mechanical ventilation and hospitalization time of ICU,and reduce the occurrence of related complications.