人工智能肠鸣音监测在克罗恩病患者术后进食时机判断的应用研究

Application of artificial intelligence intestinal sound monitoring in the decision of postoperative feeding time in Crohn's patients

目的评估人工智能肠鸣音监测对指导克罗恩病(CD)手术患者术后进食时间的作用。方法采用前瞻性的随机对照研究方法,收集2021年1月至2021年11月浙江大学医学院附属邵逸夫医院收治的60例CD手术患者,分为肠鸣音监测组与对照组,每组30例。肠鸣音监测组利用人工智能肠鸣音听诊记录仪实时监测肠鸣音恢复情况、指导患者术后早期经口进食,对照组则采用传统方法指导患者进食。比较两组患者术后肠功能恢复情况,术后首次肛门排气时间、术后开始口服营养补充液的时间、术后主要并发症发生、术后住院时间及患者满意度的差异。结果与对照组相比,肠鸣音监测组患者术后首次肛门排气时间[(58.3±1.5)h比(63.5±1.2)h,t=3.025,P=0.036)、开始口服营养补充的时间[(18.3±0.3)h比(22.1±0.7)h,t=3.521,P=0.026)、吻合口瘘的发生率(3%比7%,t=1.954,P=0.048)、住院时间[(7.2±0.4)d比(8.5±0.4)d,t=2.954,P=0.030]、患者满意度[(9.2±0.1)比(7.4±0.1),t=5.036,P=0.002)差异均有统计学意义;而进食后腹痛(13%比20%)、腹胀(20%比27%)、恶心呕吐发生率(7%比17%)差异均无统计学意义(均P>0.05)。结论利用人工智能连续肠鸣音听诊记录仪实时监测CD患者术后肠鸣音情况,评估患者肠道恢复情况,指导患者早期经口进食,可以促进肠道功能的恢复,减少术后吻合口瘘的发生,缩短住院时间。

Objective To evaluate the impact of artificial intelligence continuous bowel sound auscultation recorder on enhanced recovery after surgery for patients with Crohn's disease.Methods 60 patients with Crohn's disease who underwent surgery in Sir Run Run Shaw Hospital,Zhejiang University School of Medicine in 2021 were enrolled in this trial prospectively.They were rendered to oral nutritional supplements(ONS)after surgery according to the hint given by artificial intelligence continuous bowel sound auscultation recorder or doctor's experience.In order to investigate the clinical value of artificial intelligence continuous bowel sound auscultation recorder.Results the first postoperative flatus was earlier in the intervention group compared with control group[(58.3±1.5)h vs.(63.5±1.2)h,t=3.025,P=0.036],and the first ONS time was(18.3±0.3)h vs.(22.1±0.7)h,t=3.521,P=0.026;the incidence of postoperative complications in the intervention group was lower than that in the control group(3%vs.7%,t=1.954,P=0.048)and the postoperative hospital stay was shorter[(7.2±0.4)d vs.(8.5±0.4)d,t=2.954,P=0.030].The incidence of postoperative abdominal pain,abdominal distension,nausea,vomiting and fatigue in the intervention group was slightly lower than that in the control group,without statistically significant difference.Conclusion In patient with Crohn's disease,the artificial intelligence continuous bowel sound auscultation recorder picks up accurate postoperative exhaust time,indicates the time of fist ONS after surgery,and shorten the postoperative hospital stay,without increase postoperative complication such as abdominal pain distension,accelerates postoperative recovery.